Need help

Hi everyone. I'm new here, I'm really happy I found this forum because I have a bunch of questions that I really have no idea how find answers to, so I'm hoping you nice people will be able to help me. I just recently moved to the US, and I'm working and I do have some health insurance but it doesn't really cover anything. I've had a weight problem all my life, and after 10 years of diets I decided to get surgery. I've read a lot about it, about the options, what's available and possible, and now that I've covered that, I'd like to start the process. The problem is that the insurance that I have doesn't cover it. So this is my plea for help. Could you please, tell me, what specific insurance plans DO cover weight loss surgery? I've been going from page to page of the insurance companies but I just can't find anywhere that is simply says what is covered and what is not.

Thank you in advance!

Ancy

This is a tough question to answer.  Not only does the coverage vary from insurance company to insurance company, it varies widely policy to policy within that company.  I have found that most individual plans (meaning, not ones that you get as an employee), do NOT cover WLS.  Group plans often cover it, but it really is dependent on what the specific company subscribed to, or whether they opted for a specific WLS exclusion.

Sorry I couldn't be of more help.

 

thanks!

Insurance coverage is determined by the employer sponsoring it, so you might be better off asking which employers cover it. I have seen folks on here with Kaiser, BCBS of various flavors, Humana, etc. I have United, and others with United had simple requirements, but mine (through ING) were really restricted and I had to appeal. People have had good success through Medicare and Medicaid.

If you are looking to self insure, that will be a different question, and you may just need to go through the sites one by one. From other posts, I think it is tough to get them to cover on a self-paid plan. Have you done a search here for other, similar posts?

Don't give up hope on your current insurance. There may be a way to appeal even if WLS is excluded from your policy. In this case, I would get an advocate to help navigate those waters.

Finally, here is a blog post from Walter Lindstrom's site that explains some differences in insurance: http://wlsappeals.com/1915/walters_bariatric_surgery_blog/is-there-a-difference-when-it-comes-to-approval-for-bariatric-surgery

Good luck on your journey-