Question:
Can you buy insurance for surgery when you already have insurance with WLS exclusion
Question for a friend. What if your employers insurance doesnt include WLS? Can you buy yourself a individual policy to just use it for surgery? Will they call it pre existing? After all technically you had coverage the entire time. I am not trying or suggesting fraud just wodering if this is a possiblity. — bob-haller (posted on December 8, 2001)
December 8, 2001
When I worked for an insurance company a few years ago we did have
individual policies that one could purchas, but the premiums were horribly
expensive each month. I think the most basic policy was somewhere around
$500 + a month... You could almost save that over the course of 4 or 5
months and have enough to self-pay for the surgery. I know there are
policies out there, as self-employed people have to be able to purchase
something... I would just start calling around to the insurance companies
in your area. Try Kaiser, I know my parents have them as they are retired
and didn't get continueing coverage after my dad retired through his
employer. Also, call the insurance company you already have and double
check on your current policy. Through ours, treatment for morbid obesity
is an exclusion unless you have co-morbidities that make surgery a must.
If it was only to lose the weight and look good, my insurance would have
never covered it, but because I had Sleep Apnea, Gall-stones, Esophogeal
hernia, Ventral hernia, asthma, high blood pressure etc... I was approved
within a week. Good luck in which ever way your friend goes!!!
— Kellie Jo B.
December 8, 2001
I did that back in 1994. I bought an individual policy as my husband's
group policy had an airtight exclusion. Of course, there has to be an
individual policy available, and in WA, I don't know of an individual
policy that does not exclude WLS. The company I used in 1994 & my
husband used in 1995 left WA state in 1996. The pre-existing thing is set
by the individual states, as far as I know, but mine was as you said. Since
you are covered presently, there is no gap in coverage, so as long as the
plan you come from is appx equal, it should be fine.
— vitalady
December 8, 2001
hi bob i called a round the other day because my ins would not cover wls
it would be very high because of my weight about 500 to 600 month i
finally realized i had to pay for it my self i found a doc that would
give me a special deal since i am paying for it and the hosp is going to
let me pay for it or if i dont make enough money they would write it off
good luck sandy
— sandy E.
December 8, 2001
Around here LAP surgery is over $40,000 plus pre op tests:( Theres NO way
a regular person like a grocery store cashier could ever afford it.....
— bob-haller
December 9, 2001
Hi..FYI..HMO's are not allowed to exclude preexisting conditions. It is the
law. It doesn't mean that they have to cover WLS, but they can't exclude
you for treatment they they DO cover to to pre-existance. My two cents...I
woud search for a WLS -friendly HMO to get the best of both worlds...refer
to the Insurance section of this site, it lists insurers by state. You may
get really lucky and get an HMO that covers WLS but has to refer you out
for the surgery. Many times you get a top notch-out of network surgeon and
they pay for everything! I have yet to meet an insurer who wouldn't take
your money!!!:) Good Luck.
— Michelle P.
December 9, 2001
Bob, My surgery came to right under $50,000, but that was because I had
insurance. A lot of people who are going to self pay get a huge discount
off the price... sometimes 50% or more. I know of several people who self
payed at right around the same time I had mine and they only had to pay
$15,000 - $20,000. Unfortunately insurance jacks the price way up as they
have to make their money off of it too. Ask your surgeon and the hospital
for a price they will charge if you pay for the surgery yourself. I think
you will be suprised to find out how much less than $40,000 it can be.
— Kellie Jo B.
December 9, 2001
Hi Bob, I think i called every insurance company out there. When i thought
i found one the did not approve me because of my weight. I will be on my
husbands ins. as of Feb. My first appiontment is the 11th. That is when i
will find out if they cover due to medicaly ness. I wish all the luck. The
is a savings plan that you might what to look into, it is my last resort.
Go to www.careentree.com Sarah
— sarah C.
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