Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Approved! Yeah! Aftercare Ins Questions now. Preexisting conditions?



Recommended Posts

Upon hearing the news of my approval, my sweet hubby raised a question I thought I would ask here.

If I were to change jobs and therefore change insurance companies would aftercare be covered or a pre-existing condition?

I am so excited and never really thought about this. Anyone know?

Share this post


Link to post
Share on other sites

I changed jobs and got a new insurance. Even though I was self pay and went to Mexico, my new insurance did not classify it as a pre existing condition but as a current medical need. Although, I haven't used insurance because with the co pay and the deductible, it is still cheaper to go back to Mexico for me.

Share this post


Link to post
Share on other sites

Poodles, generally speaking if you change insurance plans with no lapse in coverage, nothing can be excluded as a pre-existing condition. That's not to say that all your fills and aftercare will automatically be covered--there are lots of reasons a carrier might not cover something like a band adjustment. But a pre-existing condition clause would NOT be one of the reasons.

Share this post


Link to post
Share on other sites

Yipeeeee Poodles!!! :dance: I needed to hear something positive today....I am very happy for you!!!:clap2:

I wanted to call so bad today, but held off. I hope to post good news myself sometime this week.

Excellent question about insurance. My husband works in automotive and with GM on shaky ground, it's hard to feel secure at a job these days. Let's hope any new insurance won't exclude WLS aftercare.

Again....I am thrilled for you....party time!!!

:confused: :laugh :thumb: :horn: :cheer2: :( :eek:

Share this post


Link to post
Share on other sites

Congratulations on setting a date! I agree with Alexandra on the preexisting clause if you change jobs.

As far as your current insurance, aren't you on TRS BC/BS ? I am on plan two and they have covered my aftercare so far. Let me know if you have any questions.

Share this post


Link to post
Share on other sites

Congratulations on setting a date! I agree with Alexandra on the preexisting clause if you change jobs.

As far as your current insurance, aren't you on TRS BC/BS ? I am on plan two and they have covered my aftercare so far. Let me know if you have any questions.

dolphin_dreams,

What does TRS BC/BS cover as far as aftercare? I never really thought to ask because when we were discussing how much less I would have to pay for prescriptions, Dr. Smith said that those savings could be used for fills. Just curious.

Audra

Share this post


Link to post
Share on other sites

I'm going to be in the same boat this year. Hubs and I are finally going to get divorced (good, bad, whatever) so I'll be going from TriCare to MN BC/BS. No idea how they are with the band. I'll have to do some footwork. Because this is a "life event" I do have a pre-existing condition clause for stuff they won't cover, hope that doesn't include the band!

Share this post


Link to post
Share on other sites

My new insurance does not coer after care at all =(

Share this post


Link to post
Share on other sites

Guess our biggest worry is that if anything goes wrong we want to make sure it is covered. Think Dr. B charges $50.00 for fills regardless, but if something needs to be replaced or opened up/etc. we want to make sure it will be covered. Think if it got that far it would be an emergency, right?

Not every school district has TRS so just wondering. But thanks Dolphin Dreams for letting me know they cover aftercare!

I still can't believe it! I am scared and excited at the same time!

Share this post


Link to post
Share on other sites

Audra,

For my fills so far (2 of them), I have only had to pay the $35 copay. My doctor does mine using sonograms and not floro so I'm not sure if you would have to pay any extra for that. I go in every 6 weeks for a checkup and they cover all of that except for the copay. Good luck!

Kendra

Share this post


Link to post
Share on other sites

Along the same lines.....what if your hubby changed jobs b4 your surgery date? Could you pay for COBRA and would the pre-approval still be valid? :D

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×