Insurance HELP!

meironhabte
on 2/14/16 9:11 am

So I've recently been looking into getting gastric bypass surgery. My first concern is insurance. Calling around to the major insurance companies I keep getting shot down with, "Oh no ma'am. we don't cover ANY type of bariatric surgeries." I was wondering if anyone knew of any companies that would, under certain policies, cover gastric bypass surgery 100%? 

Dakotapuppy
on 2/14/16 10:29 am
RNY on 01/26/16

We have Tricare and they cover all but nutrion classes.

 

Sharon SW-267
GW-165 CW-167 S.

on 2/14/16 10:32 am, edited 2/14/16 2:44 am - PA
RNY on 12/22/14

From what I understand, the state decides what is covered.  Check to see if you live in a bariatric covered state or in a bariatric not covered state. 

I applaud your efforts to find something that works for you.

But I would not bother calling around to insurance companies.  I would find a surgeon's office that does a bunch of WLS surgeries and start by asking there.  Each office that does a significant amount of WLS surgeries will have an insurance specialist that ALREADY knows more than YOU WILL EVER KNOW.

WLS takes 100 surgeries for a surgeon to get good with them - find someone who does WLS for the major part of their surgical practice.

Sharon

LadyJMarie
on 2/15/16 8:39 am

If your insurance is thru your employer they can sometimes pick and choose what benefits they will offer, (if not mandated by the state).  Check your policy's details via carrier website.. be sure to get specifies for your policy#.

Sharon SW-267
GW-165 CW-167 S.

on 2/17/16 12:27 pm - PA
RNY on 12/22/14

Through the OCA, the state sets the floor for its insurers.  So after OCA went in there is less ability for employers to pick and choose - the OCA sets the floor.

Although it makes sense to read your policy - my advice still stands - I would save myself alot of time and effort and start with the insurance experts at a surgeon's office.  

 

Sharon

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