Question:
I'm very interested having this surgery done. Will my insurance company pay for it?

I'm very interested having this surgery done. Will my insurance company pay for it? 5'1, 210lbs, health problems    — [Anonymous] (posted on February 17, 2001)

February 17, 2001
How are we suppose to know? Some policies expressly exclude it, some OK it based on co-morbidities, some OK it on Body Mass Index alone. Some cover 100% of the costs, some only 90% or 80%. Some not at all. Check with Employee Relations where you work.
   — blank first name B.

February 17, 2001
What insurance do you have?
   — Rose A.

February 17, 2001
First of all, I would like to say that even though some of the questions posted here need to provide a little more information sometimes, they are all valid questions and certainly important to the people that are asking them! Please don't be rude and condescending (B. Wesol) when responding-you'd be better off just not saying anything. Now, with that being said, insurance companies vary from state to state and even from company to company. Some policies explicitly exclude obesity type coverage or require additional information and/or tests. Please read your policy carefully (your employer should be able to provide this information if you do not already have it) and if there doesn't appear to be a specific exclusion move forward. Visit a surgeon and have them pursue it for you. If I can provide any assistance please do not hesitate to contact me.
   — Sharon R.

February 18, 2001
It really doesn't matter which insurance company you have. It depends which plan your employer has and how they decide to implement it. My insurance is through a hospital connected (physically) to the one where I had WLS. Both hospitals have the -same- insurance company. My insurance covers WLS just on BMI alone. Ironically, the employess of the hospital where I had the surgery done are specifically -not- covered for WLS. Same insurance company, different employers. Different groups of employees; administrators, skilled staff, maintenance, and less than .8 fulltime may be covered at different levels. How are we suppose to know what someone's coverage is, even if we know the insurance company? Check with personnel, or get out the big benefit book evryone got just after the first of the year and look it up.
   — blank first name B.