Morbid Obesity Surgery Exclusion ... Is there anything I can do?
I reviewed my healthy insurance policy from BCBS today and it has a Morbid Obesity Surgery exclusion. I did not realize this until today. I have an appt with my surgeon in a couple weeks to discussion options for a revision. I was thinking they covered WLS surgery as they use to but now it appears my employer does not. Any ideas,can surgeons office submit paperwork to see if they would override or is that out of the question?
Be sure and speak to your surgeon's office about your options. Also please post this question on our Insurance, Cash Pay and Financing for WLS Forum too.
Doubtful - that is what exclusions are for.
I was banded in Mexico and would have gone to Mexico for revision to the sleeve if my insurance had not paid for the revision.
Best of luck to you.
Getting rid of the Crapband was the best decision ever...
unfortunately i see this more and more every day. an exclusion is just that, exluded in coverage. can you get a different coverage? sometimes companies offer multiple policies, they may be different, check them all. if you have a spouse check that policy. a surgeon has nothing to do with your policy, it is between you and your insurance co, not surgeon. if you are asking about appealing, an exclusion is pretty iron clad....that is why everyone should get a copy of , read and know their subscriber agreement, not just for this example, but for all of our healthcare needs...good luck to you...
on 8/11/13 2:03 pm
Sadly, no. Ins co's require additional premiums for WLS and if they aren't paid they have no reason to cover any WLS let alone a revision. It's really quite expensive for this rider and with the economy being what it is most employers do not pay the additional premiums. Most ins co's are also going to a once in a lifetime WLS even if they do cover bariatrics. Doesn't matter in the least who paid for the original surgery, even if it was self pay that was your once in a lifetime WLS.
Sorry.