Question:
Is obesity a pre-existing condition?

I have BC/BS az insurance. Yes, I know- it is crappy. My question here though- is I spoke with them this morning. They told me that getting WLS would be impossible for me until my 12 month waiting period is over because I have a pre-existing condition. The lady was very beat around the bush like- but saying that being over weight is a pre-existing condition. Is this true? If so, I have not even been to a dr since December- and that was just because I had a horrible horrible cold- and never mentioned a word to them about my weight. So that means either way- I should be ok right? Please someone put my mind to rest!!    — hopefulnickster (posted on June 5, 2007)

June 5, 2007
I would call back 3 or 4 times and talk to different people. Sometimes you get different answers. Once you've gotten the same answer a few times, that is probably the right one. Insurance companies like BCBS have so many customer service reps, they consistantly give different information. I had something covered once that wasn't supposed to be covered becuase there were so many notes on my account by reps who had given me so many different answers, they just allowed it to be covered. Good luck!
   — itzmetami

June 5, 2007
The answer is Yes!!! I had a new insurance and they had told me they do not cover pre existing conditions until one year after my insurance enrollment. I was upset but what I did was in the one year I waited it to be over I completed all of the requirements for surgery. Read my profile when you get a chance. Believe it or not that year came around quick. I actually have surgery in 7 days. Goodluck to you
   — Big_Sassy

June 5, 2007
First Point - Do you qualify for a waiver from pre-existing conditions? If you've had health insurance with another company with no more than 63 days without coverage then there is a federal law that automatically covers pre-existing conditions. You just need to get a certificate from your prior insurance company and your new company will cover you fully..... Second Point - Different insurance companies will treat your pre-existing pbesity differently. Some will count back to the last time you discussed your weight with your physician, some will count back to the last date your physician weighed you even if you did not discuss your weight, and some will count from the first date of coverage since the obesity was obviously known to you. Many do not consider obesity a pre-existing condition, UNLESS you have EVER discussed weight loss surgery with your physician (documented of course)... Best way to check it out is to call several times and then to get your physician to go ahead and submit the referral. Even if customer service says no, there is no harm in getting your physician to try and get the referral pushed through. hope this helps.
   — JGDugar

June 5, 2007
I would recommend you start going to the doctor and have him monitor your weight. I have BC/BS TRS of Texas and they require a six month history of doctor visits before approving surgery. I have a friend who just went through it and he is having surgery this summer. I went once a month and had my doctor record my wieght while we discuss how I was doing. Also have his state in his records what kind of diet you are following. Hope this helps and good luck!!
   — Laural D.

June 5, 2007
Call the customer service # & ask for a copy of your policy that has to do with WLS surgery. Mine was about 6 pages & I had it in about a week. It spelled out every detail. Then you can ask specific questions-what does this word mean? Where does it explain "pre-exisiting conditions"?--If this is not in this part of the print out. I did not think I could get a copy, but I could not get answers until I was asking them the correct questions. God Bless & best of luck. It is the best thing I've ever done for myself!!! (Surgery 2/27/07 after 19 months of waiting & I'm down 83 lbs!!! MK
   — asinmouse