Revision from band too Gastric sleeve Insurance woes

khilley
on 10/31/15 5:03 am - gaylord, MI

In 2011 I had to have my band removed due to slip. I had blue cross Was told by my surgeon to wait a few years and have a different kind of surgery. long story short gained all 145 lbs lost back. found new surgeon and starting process to get gastric sleeve but our new insurance company consumers mutual wants me to start whole process over. plus only pay for 50% of the surgery. Not sure what to do.

Karen R.
on 10/31/15 5:58 am - Amelia, OH
Revision on 09/10/15

It's the time of the year where employers offer new policies to their employees. I would ask your HR person to change their obesity coverage guidelines and coverage. Or, maybe look for different coverage through the federal exchange.

Karen

Ht: 5'3"/Pre-Band Weight:256/Revision to RNY 9/10/15-Weight: 219--GW: 115--CW 105

purranha
on 11/5/15 4:31 am

FYI, NONE of the policies on the federal exchange cover weight loss surgery, medications of anything else related. I have carried a $600 per month policy (just for me, no dependents) for almost 2 years now and there is an outright exclusion for bariatrics and anything associated with it. I sniffed around looking for a potentially different policy within the exchange and all of them are like that. Even if you try to call up an insurance company and buy a policy individually, it's still a no go. They steer you back towards the marketplace. 

cmcelfish
on 11/6/15 2:04 pm

put in an appeal to insurance company you have a few . Insurance companies are real fast to say no . Get all the bletters of medical necessity stating why you needed it done yesterday. Keep copies of everything . Keep detailed notes names of everyone you spoke with. Keep all letters they send you . If you don't have luck with insurance company you can complain to hour state insurance commissioner even consider going to leagual aid. Lots of luck

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