Question:
HELP,HELP, HELP insurance question

I would like to have this surgery and I dont have any insurance, if I went out and got insurance and a few months after getting the insurance if I submitted a claim like this one would they automatacally deny the claim being I will be new with them? Also, does anyone know of any discounts I could get with me not having insurance?    — DBXX (posted on April 10, 2002)

April 10, 2002
The previous post is correct most policies have a pre existing exclusion on a private policy. Your best bet is to try to find a job that has insurance. Most companies do not have pre existing clauses in their plans. Even Walmart has ok insurance. If that is not possible try calling the hospital and see if they will offer a discount if you pay the bill right away. If you can finance you will be able to pay the bill right away and they may give you some sort of discount. The previous post said Public Aid but I bill public aid for a living and unless you have tons of stuff wrong with you, you will have an almost impossible time getting them to approve this kind of surgery. Good Luck to you
   — Dawn L.

April 10, 2002
Hi Danielle. Unfortunately I think insurance companies have the right to deny coverage for many reasons. It is unethical, but I dont think its illegal. The best thing I can think of is to try to find a job that has insurance and they will automatically cover you. Typically they will do it on open enrollment without a physical or anything, just your name and ss#. I know it is hard to just uproot yourself and find a new job, but if you know what you want get out there and search. You would be amazed at the information that you can inquire over the phone as well. Good Luck!
   — Tara J.

April 10, 2002
I believe the other posters are correct. I tried desperately to pick up individual ins, but no luck. Picked up 3rd job that will cover(fingers crossed). But, I do hear that most WalMart's do exclude the surgery. Best bet is job with ins. You could also try Vocational rehab. in your state. I do know they pay if funds are available, & medically necessary because of health hindering job performance. Medicaid if disabled & qualify financially. Good Luck!
   — Belinda W.

April 10, 2002
Chances of finding an individual policy that covers WLS that will accept you is pretty slim. Weight alone they can deny you. Plus most likely you have some of the normal comorbid conditions. I just wanted to let you know that IF you are lucky enough to get on a policy you may not have to wait to start the WLS process. I think you're assuming they'll deny you on the basis of it being a pre-existing condition. As I understand it though, unless you have actually been seen for or treated for something within the last 12 months by a doctor it can't be considered a pre-existing condition. In other words, if you're morbidly obese but have not been seen specifically for that reason or treated for your obesity they can't hold you to that 12 month wait on a pre-existing condition clause. At least that is what I was told. Hope it helps.
   — Shelly S.

April 10, 2002
My daughter has a discount health plan called care entree, she is getting her surgery for less than $7000 including the hospital stay. Her email is [email protected] if you want to ask about it.
   — Brenda T.

April 10, 2002
Most HMO's don't have pre-existing time limits. You may want to check into an HMO.
   — Sharon H.

April 11, 2002
I had to buy an individual policy from Blue Cross Blue Sheild/Traditional Blue. It's $215.00 a month. They don't ask questions about your health, weight, etc. There is a pre-existing condition clause that if you have a medical condition for which medical advice, care or treatment was recommended or received 180 days BEFORE your enrollment date, any services you receive to treat that condition within the first 180 days after your enrollment date will not be paid by your non-group coverage. So if you didn't speak at all to a physician about your weight 6 months prior to getting coverage, you would still be covered. Even if you did seek treatment, the worst would be you'd have to wait 6 months. That's better than not getting it at all. (My policy started in January, and my surgery is scheduled for May). www.bcbsm.com is there web site. I'm from Michigan, so you need to check and see if it's a covered procedure in your state. Hopefully so. I am not able to work due to my weight related health problems, so getting a job with insurance wasn't an option for me. Maybe that's your situation too, I don't know. I hope things work out for you.
   — lerli1