I have BCBS through my employer and I am also covered under my husbands United Healthcare.... would they submit to both insurance companies? just curious

I have recently lost my insurance due to job loss, I was on a group policy. If anyone knows of a company that will cover you after having the lapband please advise. I know insurance companies will cover the surgery so why should it be so hard to get coverage.

I am sorry this does not answer your question, I was a self pay. I am hoping someone can help.

Yes. That situation is co-insurance. Your coverage through BCBS is your primary coverage. Assuming both policies cover banding, it would work this way: First, BCBS would pay whatever amounts they cover. Then United would cover some amount of the portion not covered by BCBS,

Thank you, I knew it worked for other medical reasons but I didnt know if they bothered submitting it for lapband procedure. from what I read it can be difficult to be approved.

I have recently lost my insurance due to job loss, I was on a group policy. If anyone knows of a company that will cover you after having the LAP-BAND® please advise. I know insurance companies will cover the surgery so why should it be so hard to get coverage.

I am sorry this does not answer your question, I was a self pay. I am hoping someone can help.

I went from a group policy to an individual one in 2007 when I was laid off from my job and went out on my own. I was able to get good coverage in spite of some chronic medical issues (hypertension, asthma) but there was a one year exclusion for preexisting conditions on those issues.

Are you unable to get coverage at all, or are they just excluding the band as a preexisting condition?

kagead

Broken Angel....I suggest you call both insurance companies (there should be a customer service phone number on each insurance card). ASK if your policy covers lap band surgery. If yes, then ask what their requirements are to qualify you for the surgery, what requirements they have otherwise....by this, find out what surgeons are covered under the policy (since you are seeking co-insurance, you'll need a surgeon covered by both policies I believe) and if there are requirements about the location where the surgery takes place (I've read comments here that some insurance companies REQUIRE inpatient overnight or require the surgery to be done at a "center of excellence". Ask if they require weight histories, pre-op diets....anything you can think of.

Thank you so much... I will do that. That is definatly good information to know ahead of time.

Broken Angel....I suggest you call both insurance companies (there should be a customer service phone number on each insurance card). ASK if your policy covers LAP-BAND® surgery. If yes, then ask what their requirements are to qualify you for the surgery, what requirements they have otherwise....by this, find out what surgeons are covered under the policy (since you are seeking co-insurance, you'll need a surgeon covered by both policies I believe) and if there are requirements about the location where the surgery takes place (I've read comments here that some insurance companies REQUIRE inpatient overnight or require the surgery to be done at a "center of excellence". Ask if they require weight histories, pre-op diets....anything you can think of.

Completely agree with you...@brokenangel, If you need to get more details on Obesity or Bariatric Surgery Insurance Information

Hope this will help you...

Thanks

Edited January 1, 201016 yr by alicez

One will be considered your primary insurance.. the other your secondary. :biggrin:

I have recently lost my insurance due to job loss, I was on a group policy. If anyone knows of a company that will cover you after having the LAP-BAND® please advise. I know insurance companies will cover the surgery so why should it be so hard to get coverage.

I am sorry this does not answer your question, I was a self pay. I am hoping someone can help.

Sorry to threadjack, but I wanted to address this so that you don't make the same mistake I did.

Since you lost your job, you should be eligible for COBRA. Do whatever it takes to get on COBRA.... once you exhaust 18 months, you will be eligible for portability through HIPAA... which means individual plans won't be able to deny you coverage due to pre-existing conditions.

This is absolutely crucial.... otherwise, as I've found out the hard way, you're going to have one hell of a time finding a plan to cover you.

I lost my coverage through my parent's group plan 3 weeks after my surgery, when I turned 23. My COBRA was $1900/month (yes, per month).... so I was basically screwed.... considering that's more than I made at the time. Since then, I have been able to pick up temporary insurance, but no respectable plan will touch me with a ten foot pole until I'm at least 18 months out of surgery.... and even then, I have a feeling it's going to be a fight.

Find out about COBRA asap. It's not cheap, but it's pretty much your only guaranteed option at this point.

Good luck!!!