Question:
My current insurance doesn't cover WLS. I have had my first appt. w/ doctor

and I think they submitted the bill for initial appt. to insurance even though there is a written exclusion. If I were to change insurance companies now to a policy that covers WLS, would it now be considered a pre-existing condition because of that appt.?    — [Anonymous] (posted on January 12, 2002)

January 12, 2002
When I started my new job I had a choice of 2 insurances and the one I thought would cover the surgery I could not get because of pre exsisting conditions, the other one covered me no matter what, and they paid for the surgery with no problems at all. It cost me the $10.00 co-pays. If they have a pre existing clause they won't pay for anything you have been to Dr. for in past 3 months. If your employer is switching I think they have to cover you for all health problems. I have Humanna HMO and no problems I was really suprised, Good Luck
   — KAREN T.

January 12, 2002
It was also my undestanding that congress passes new legislation making insurance companies cover this type of surgery. Contact your local congressman!!! Another resource to look into is the Department of Rehabilitation. Commonly referred to as Voc Rehab. If your weight is preventing you from working or getting a job, etc, they might be able to cover it.
   — [Anonymous]

January 12, 2002
It may very well be worth getting a COBRA policy from your current insurance, and going through the appeal process with them. I am in a similar situation and am considering keeping my current insurance COBRA just in case I may need some follow-up or emergency treatment after surgery. My job is most likely going to be phased out by late spring and I'm hoping to have had surgery and a couple of weeks recovery time by then, but you never know! Good Luck to You!
   — [Anonymous]

January 13, 2002
I believe that if you have been covered under your current plan for the last consecutive 12 mos. and switch insurance either because of a new job or open enrollment AND there hasn't been more than a 30 day lapse in coverage...then they CANNOT get you with a pre-existing condition. You have to supply the new insurance company with a certificate of "credible coverage" showing that you were covered continuously over the last 12 mos. I am very confident that is how the system works...it is federal law. If your plan is to change jobs, you should be able to get COBRA to cover until the new insurance begins. That would keep you continuously covered. If I am wrong...someone e mail me and let me know...But, I think this is correct.
   — Karen B.