We really need universal healthcare...

I was checking into my employers medical plan to see what they exclude about weight loss.  This is absolutely apalling to me!  They won't cover ANYTHING that helps you lose weight.  They won't even cover going to a nutritionist!!  Absolutely absurd... I can't even begin to tell you how much I hate insurance companies in America. I firmly believe we should have universal healthcare much like Canada.  I do not wish to debate the subject though.. I'm just stating my opinion..and voicing my distaste with insurance companies. Medical Expenses Not Covered

 

The Plan will not provide benefits for any of the items listed in this section, regardless of Medical Necessity or recommendation of a Health Care Provider. The following illustrative list is intended to give you a description of expenses for services and supplies not covered by the Plan, including: • treatment, procedures, services and / or supplies incurred related to weight reduction, whether or not the treatment, procedures, services and / or supplies are considered Medically Necessary,

including, but not limited to:

– nutritional or dietary counseling,

– weight loss medications,

– weight loss programs,

– health club fees, and

– procedures or surgeries (including gastric bypass).

 

wow that sucks. i am shocked to see that it is so inclusive! not even a nutritionist?? what do they expect you to do? what happened to preventative medicine? they'd rather wait until you have heart disease and liver failure and then deal with you then.  i'm so sorry. i completely agreed wih the universal healthcare bit. have you seen sicko?

Reading the exclusion sections makes my blood boil!  What's even worse is they said in the summary, "Preventative Care:  100%".  There really isn't much insurance will pay for these days.. Sickening...   No I haven't seen Sicko yet but I do plan on watching it.  I'm familiar with Michael Moore. While I'll admit he's a little eccentric he is dead-on about America's healthcare industry.

No debate here, I've always believed that we need a universal healthcare system in the U.S.

I believe you do have the option of opting out of healthcare at work, and seeking your own healthcare. You do risk paying a high premium since they offer a group rate at work.. I have Aetna PPO it pays up to 25000 lifetime max for bariatric procedures.. There are also other healthcare companies out there for you.

Actually, that's the reason why I looked into my employer's healthcare. I'm not eligible for it for a while because I am a contractor. I was considering purchasing a more expensive individual plan that would cover me.  My problem is that I have to put my wife on the insurance because I can't put her on my employer's plan if I'm not on it..  She just recently stopped smoking, is on anti-depressant/anxiety meds, and is probably going to need to be on Nexium. Those are the top 3 things that the insurance companies use to jack your rates to $800 a month or more.  I haven't applied for the insurance plans yet but I have the paperwork in hand.

eh i have private insurance since i got kicked off my parents' plan and have zero benefits at the internship i'm starting - they don't cover jack! i get one physical a year and a small discount from the full price of drugs. and the fact that i had taken antidepressants in the past made them put a rider on it saying they will never cover any kind of psychiatric anything ever. at least with a group plan, they can't make all those exceptions (or so i've heard). i can't wait.... just read very carefully and compare lots of options if you do decide to go off on your own plan...

Your post brings up another dilemma I've been pondering in my little brain.  If I decide to have WLS and I end up having to self-pay what kind of complications is the going to pose for me in the future?  Will my employer's plan cover my post-op care or will I have to self pay those as well?  I know that if I choose an insurance plan outside of my employer I DEFINITELY risk being denied coverage on post-op care. However, if my insurance never lapses do they HAVE to cover me, employer or otherwise?  Surely, individual insurance would jack the rates up if they did cover it. .... Then there's the other side, what if I go with individual/personal insurance and have WLS, will the same complications arise from that?   These questions are somewhat rhetorical.. I'll have to answer these on my own with my insurance providers.. Just helps me to write these things out.. :)

there are definitely insurance companies that will not cover you if you currently have a lap band or have had gastric bypass in the past - so it can be an issue for the rest of your life, not just in terms of immediate post-op care. it seems that it is much harder to get insurance if you have had any kind of bariatric surgery. you can also investigate going to another country for bariatric surgery, which if you are self-pay, will be a lot cheaper. but that opens up a whole other box of issues... i know with plastic surgery, if you are self-pay and have complications afterwards, most of time insurance will not cover any of that.

be careful what you wish for.... my husband is English and I have seen his family members suffer over and over because of the NHS (national health service). It seems utopian, I know it does... but it is not...  bearuacrats are no better about making decisions for healthcare than insurance company people.  The difference is that we have the right to appeal or purchase other coverage. I was SHOCKED to see a hospital ward in the UK.  20 men in a room.  We could not call the patient because he was unable to walk to the nurses station to take the call!  visiting allowed for only 2 hours 2 times per day...  and only 2 visitors at a time. He did finally get moved to a private room, with unlimited visiting hours.  There was a reason, he died 7 hours later....