Question:
Employer funding WLS

I have approached my employer about possibly paying for my WLS because of an exclusion we have in our insurance policy. I talked with HR today and they told me to go ahead and have my doctor request approval from our insurance company, if they deny it, then for me to write a personal letter asking them to reconsider and if they still deny it then my employer will look into paying for it themselves. My question is my insurance is 80/20. If my employer funds the operation will I have a deductable or will they cover it 100%? Has anyone else ever had their employer pay for the operation and could you tell me how did they go about doing that.    — [Anonymous] (posted on February 16, 2001)

February 16, 2001
Of course, I can't speak for your employer; however, if they do go outside of the contract to pay for your surgery I am almost positive they will go with whatever the norm is for your policy. They will not agree to pay for all of it when the norm is that you pay 20%. You should have a maximum out of pocket expense related to your policy though. I just recently went through this process with my employer and they have been wonderful! My employer is only agreeing to guarantee payment on this procedure according to what my insurance would normally pay if it had been included in my policy. Hope this helps and best of luck to you.
   — Sharon R.