Insurance

Hello everyone. I am just beginning this process and wanted to see if anyone could give me some insight on their experience with insurance. A couple things: Have any of you switched insurance after the surgery? For example, changed jobs, or were on your parents insurance and then got your own. I am simply curious if the insurers consider WLS a pre-existing condition to which they either wont insure you to begin with or they'll exclude any complications that may come up. Also, does anyone know if it matters how long you have the insurance before the approval process? Will they say no if you're a new customer? Well, if anyone can help, I'd appreciate it. Thanks!

Well, I really hope insurance companies dont consider WLS a pre-exisiting condition! Oh well, its too late for me now! I do however believe that atleast my insurance (ConnectCare) does require that you have been on their coverage for a year. Hope that Helps! Ellen

All very good questions, I am fighting with my insurance company right now to get approved but I can give you some examples of things I have heard. As far as being a new customer, they cannot pick and chose what they cover based on how long you have been a customer. My insurance was effective June 1st and on June 7th my doctor sent in the request for WLS. I was denied but not because I was a new customer, it was simply because of the exclusion in the policy. As far as pre-existing conditions if and when you change insurance try to do it within 30 days of loosing you old coverage, don't let time be your enemy. Make sure to get a certificate of coverage from your old insurance company and give it to the new insurance company ASAP (within 30 days) this will help with pre-existing clauses. If for some reason you cannot get insurance within 30 days of loosing the other one try to cobra, if you can afford it. Otherwise make sure the insurance company you chose allows you to be covered, you can always call ahead and ask a general question about the policy even if you aren't on it yet. Hope this helps, I will definitely like to hear what answers you get though. Maybe my info is wrong or not accurate but it has been my experience so far. Good luck. Tara

I only had my insurance 3months before I had surgery... so I was definitely a "new customer". I had no problem getting approved.

Thanks for the responses, I appreciate seeing what everyone else's experiences are. When I called Blue Cross about if they consider having WLS a pre-existing, the customer service person couldn't answer, said it was up to the underwriters. I've also read on this site other people talking about what Tara said, if you have coverage for at least 12 consecutive months with no gap of more than 60 or so days between insurers, a new company can't say anything about pre-existing. Of course, who knows. I've been going out with a lawyer who is also an exec at an insurance company. They don't do health coverage, just life and other financial planning stuff... but, he's been answering some of my questions. I'm going to try to get him to clarify some of the information and I'll be sure to post it here. I'm still in the very beginning stages of this, doing the research, etc. I don't currently even have insurance. I wrote about this in my profile, I applied to get Blue Cross HMO and they denied me, saying that if I lose 40 lbs and keep it off for 6 months with proof from a Dr, that they would approve me. Otherwise they would give me the PPO at 50% more than what anyone else my age (23) would pay. At first I didn't think I should do that since the PPO's cover a whole lot less, but now I don't think it would be so bad. It's essentially paying about 5k vs 2k (and an extra $50/month), a big difference but still do-able. That lawyer/insurance guy said he thinks there's ways around it and that he can get me approved for the HMO. Hopefully he can, otherwise it's good to have a backup option. Sorry this is so long winded! Thanks again!