Question:
Anyone able to get Individual Health Insurance as a Post-op?

I just sent in an application for BC/BS PPO for myself & my children. We've been covered by my husband's insurance through his job for a couple years & they covered my WLS back in 10/2002. But now the insurance rates for the family plan are going way up per paycheck so we've been looking into an Individual Policy for myself & the kids. I just spoke w/ a BC/BS representative & was told anyone who has had WLS cannot be covered until they're @ least 5 years out from having surgery, to make sure there's no complications & their weight stabilizes. I'm currently a SAHM w/ a 2 1/2 yr old & an almost 4 yr old. Are there any other Insurance Companies out there that would be willing to cover me? Thanks for your help...Jamie / Open RNY: 10/09/02 / -85 lbs.    — j-bird333 (posted on April 7, 2003)

April 7, 2003
I don't know where you're writing from but I'm in Pennsylvania and have Blue Cross PPO. I had a hard time getting insurance because of my weight prior to surgery. It seems that every insurance company has what they call "open enrollment" each year and this usually means that they have to accept everyone regardless of pre-existing conditions. You'll have to call up and ask when they do this. Also a few years ago Clinton passed a law that says as long as you're coming from another insurance company the new company must accept you, again regardless of any condition or surgery in the past. Please look into this. My application for Blue Cross didn't have one heatlh question...I basiclally just signed my name and I was in. They covered my surgery 2 months later.
   — Cindi S.

April 7, 2003
I was told the same thing by BCBS of Florida. I had been covered by a group plan through my employer when he cancelled the plan on me and tried to just re-start an individual policy and they told me that BCBS would not cover me on an individual policy for 5 yeard because of the WLS. That is actually the case with ALL insurance companies. I can get covered through a group policy but not an individual policy. It's amazing, isn't it. Before surgery when you are MO you can't get an individual policy because you are overweight and after WLS they won't cover you even though you are now thin and much healthier than you were before. Insurance companies are ridiculous and it's time the powers that be (i.e. the government) did something to fix the problems there. End rant =)
   — KelBurt

April 7, 2003
I may depend on the State. I'm in NJ, self-employed, individual policy...had open RNY on 8/99 approved with Prudential HMO, switched to BC/BS traditional Indemnity who approved my transection after staple line disruption a couple of months after signing up, May/2002 switched to Oxford Liberty PPO with no questions asked about prior health or surgeries. I never dealt with the pre-existing conditions clause as there was no break in coverage. I think you should call your State Dept. of Insurance and ask about your rights.
   — Leslie F.

April 7, 2003
Thanks for your input, everyone. Yes, Kelli, is it BCBS of Florida I'm dealing with. That really does suck. It's like a no win situation. We'll see what happens from here...
   — j-bird333