Question:
I heard somewhere the preexsisting is illiegal when it comes morbid obesity...

I am sure this has been asked before, but I assure you that I looked and could not find anything about it- Is it true that by law your obesity can not to considered pre-exsisting? That is now my only concern with getting approved. And I'm not sure if its a plus or a negative that I have never seen a doctor for my morbid obesity. I was thinking that was good since they couldn't scream "PRE-EXSISTING CONDITION" but on the other hand it showed no serious problems. What do you think? Thanks!    — karmiausnic (posted on June 8, 2002)

June 8, 2002
I am not sure if it's illegal or not but I know that my doctor's bill was rejected by my old insurance company for claims because he diagnosed me as morbidly obese. There is a plus and a negative to not having gone to a doctor yet for your morbid obesity. I know that if you've received any medical advice or treatment for a condition before you got your insurance, there will be a pre-existing conditions clause.UNLESS you had insurance before that without a 62 day break If you didn't receive any advice or treatment, then you can treat under your insurance for that condition and the insurance company has no right to deny you. However, when insurance companies approve WLS, they require 6months or sometimes, depending on your insurance company, up to 5 years of medically supervised dieting. and sometimes even want proof that you've been morbidly obese for over 5 years...something like that. Someone please correct me if I'm wrong. I was in the same exact situation with my old insurance. I quickly cancelled it because I wasn't patient enough to wait a whole 6 months. That was last year and I'm still pre-op. Now I have insurance that has no pre-existing conditions clause and has a good record of paying for this surgery. I just hope rules don't change before I have mine lol. Good luck to you!
   — Samar M.

June 8, 2002
My (limited) understanding about health insurance is that as long as you don't let your health insurance lapse for a certain number of days, there is no such thing as "pre-existing" for ANY condition anymore. We can thank President Clinton for this! It's one of the few things that he proposed in his National Healthcare Bill that passed.
   — Kristie B.

June 9, 2002
I would say that if you don't have a gap in the insurance you would be better off having seen a doctor for MO because it does show a specific history. On the other hand, if you have a gap its probably best that you haven't. I had a pre-existing waiting period with my current insurance but because I had never seen a doctor specifically for my weight, it didn't affect my approval for WLS. In this situation, the key would be that you never got DIAGNOSED with MO (within the last 6 months or a year, I can't remember which) but that your records still indicate your weight as being within that range. Basically, show the weight was there, but no codes fo MO were submitted to insurance or anything. That's what worked for me, anyway. Good luck!! =)
   — K. Joyce Smith