Question:
Has anyone switched insurance to get WLS?
I currently have BC/BS of Texas which does not allow the surgery. My husband has Healthpartners which does allow the surgery. Has anyone switched insurances and had it work out? How long would I need to be with a new insurance before approaching them for the surgery? Thanks for your help! — oneten (posted on July 28, 2006)
July 28, 2006
have not switched but want to after the first of the year for the same
reason. would love to know.
— donna957
July 28, 2006
My husband got a new job, and as soon as the 90 day wait was up, and our
insurance kicked in I started my Dr. appt.s to get the surgery. It took
only 3 months from beginning to surgery! Good luck to you!
— Sarah C.
July 28, 2006
I had an hmo-Cape and they would not cover it unless I had all the exact
paper work down to the exact dates-- which my doctors did not have all
that, so they gave me the run around. I thought smart, my boyfriend at the
time, who just got a job in feb. I had him check out what kind of benifit
plan they had. Well he had BC/BS, after 6 mo. of work. It was may 19th we
were getting married, june 20th pshy. eval. and consutation, and now
surgery scheduled for Aug. 3rd! Fast plan and it worked! They covered it
all except for the lovenox shots--Cori Centers did it all, no paper work
from anything! A letter from my pcp and that was all, they took care of
it--even my approval from bc/bs--I did nothing, within 2 weeks I had a
surgery date! MICHIGAN=BC/BS=CORI CENTER =THE BEST
— ALEXISRAY
July 28, 2006
Check the policy by asking people who have the new insurance. Thats what I
did. once a year, we have the opportunity to change. within less than a
month, I knew it would approve me.
— geneswife
July 28, 2006
I had Blue Care Network and they denied me. I then switched to Blue
Cross/Blue Shield when we had open enrollment at work and never had another
problem. They covered everything except my deductible.
— Danita S.
July 29, 2006
I had Premera Blue Cross, and when I checked to see if they covered WLS I
found they had a written exclusion. I tried anyway, and was denied. Then,
at open enrollment I switched to Grouphealth because I had found that they
cover WLS if you meet their criteria, which I did. They had lots of hoops
to jump through, and I had to pre-pay for one year of nutritional guidance
(which was a total joke) that cost me $1470 out-of-pocket. You know what,
though? After all that work and all the complaining and frustration, it was
totally worth it. Life is good. Good luck to you!
— buglebird
July 30, 2006
My insurance through my employer has a written exclusion. Luckily, when I
did my husbands paperwork for his insurance for him and the kids through
his work (Taco Bell), I went ahead and included myself so I would have dual
coverage. At that time I had no idea his insurance "Great West"
covered it! I am so glad I included myself because Great West told me sinc
my insurance Providence Health excludes it, all my doctors, hospital,
etc... have to do is include a copy of that denial when they send the
billing and Great West will kick into primary place and cover it. Hope
this helps.
— ADOLLFORYOU
July 30, 2006
I have never switched, but after we got married, I added my husband to my
insurance. He started making appointments like crazy (he had never had
insurance before).. So pretty much 6 months after he signed up with my
insurance he had surgery, LOL... (they made him do the 6 mos. dr.
supervised diet, and as soon as he got done we went for it!!!).. I had my
plastic surgery about 8 days before he had his surgery (so I still had my
drains in while I was sitting at the hospital with him overnight!!!)
— GAYLE CARMACK-LYONS
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