Question:
PLEASE HELP!! Secondary Insurance Question...(I'm in MA)

I have United Health Care...who won't cover ANYTHING related to weight loss...anyway, I was considering Mexico - did some research and liked what I saw...but It still makes me a little nervous just because if there were complications, insurance wouldn't pay for that either...that, and I am, like IN LOVE with my surgeon and the staff at her hospital!!! So I'd really love to stick with her. ok ok on to the question: Would anyone have any suggestions on getting a secondary insurance? I've heard BC/BS of New England is great, but are they good when it's not a group plan? Do you think a secondary insurance would approve/pay when my primary doesn't??    — lillydawg (posted on February 24, 2006)

February 24, 2006
LILLIAN,I ALSO HAVE UNITED HEALTH CARE AND THEY COVERD EVERYTHING ,I DIDNT HAVE TO FIGHT IT OR ANYTHING.IM IN MO,MY SURGEN TOLD MY INSURANCE COMP THAT I NEEDED THE SURGERY,I HAD HIGH BLOOD P AND DIABETIC,MY KNEES HURT MY BACK I JUST FELT ALFULL. DR OPIE SAVED MY LIFE AND I WONT FORGET IT OR GO BACK TO BEING FAT I WONT, HE GAVE ME THE TOOL NOW ITS UP TO ME TO DO THE REST. MAY GOD BLESS YOU AND HELP YOU FINE A WAY TO HAVE THIS SURGERY. LOL JANICE
   — SWEETPEA52

February 25, 2006
If they are not covering anything, it may be that the employer who purchased the plan does not want to cover WLS. Check with the benefits department. If you go the Individual Plan route, be prepared for careful scrutiny of your medical history. If they see that you are planning to have this surgery, they may reject you. They could also reject you just based on your BMI. They can impose a waiting period. Just be honest in your health history and see where it leads. If they cover you, there is no issue if your primary covers or not. It only matters if you are asking for Coordination of Benefits (COB). In your case, I would not suggest COB as you already know the answer and it will cause a billing nightmare. Best of luck! Joshua - Lap RNY 1/9/06 280-263-229
   — nursenut

February 25, 2006
come to the DS forum, as the DS is excluded even by those covered by insurance generally, many DS'ers go to Mexico, Brazil, or Spain for their DS's, so much that we chit chat about the different waitresses. tour guides and the like, lots of info there, come on over and ask away, U might want a DS too, many of us choose to pay than have the free RNY,
   — walter A.

February 25, 2006
Thanks for all the replies!! The only thing with UHC (in Massachusetts, anyway) is that they have an airtight exemption policy for this and anything else having to do with weightloss. Many people have fought through appeal after appeal and even involved lawyers...I'll still of course try and send my own appeals, but I don't see much hope and neither does anyone else I've talked to who has dealt with them. So yeah, that's why I'm thinking about trying a secondary insurance before going ahead and having the surgery in mexico....so any suggestions as to which company I should try for secondary insurance? Oh yeah, and in MA, insurance companies can't deny or discriminate against you because of your weight and as long as you've had consistant insurance, they can't consider morbid obesity a pre-existing condition...so there are two cards playing in my favor anyway! :)
   — lillydawg