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insurance question, life after banding help??



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:help:

i currently weigh 225 and am being banded on thursday. My husband and I are self employed and I am on a ridiculous insurance plan with a ridiculous deductible. I could not get on my families health insurance plan because of my weight. I am hoping when I lose some weight to change over. here is my question. has anyone had any difficulty getting coverage due to having this procedure?? wouldn't that be my luck ...turned down because i am too heavy and then turned down because i tried something to reduce it? :angry I am concerned and need some input because my husband is worried, as well. we are paying for the band privately but as you know on insurance forms you have to list surgeries. thanks, tina

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My husband and I are both self employed, and I work for him.

We have Blue Cross Blue Shield of Florida.

To my understanding, you cannot be denied insurance if it is under a company policy for any reason (check with the new ins co first) I think each state has different rules governed by the ins commssioner. I was told this is the reason most small group policies have higher premiums.

I was also told by 2 different ins carriers here that if you are 30% over your healthy weight - they can deny you coverage if you try and get a personal policy. We are much like you - stuck with having to have a group plan so I can have insurance coverage.

I do not know on the policies if you have been banded, but I don't see why a personal policy won't cover you if you are in your healthy weight range and then apply for it.

I will be finding out too if I can be switched over to a regular personal plan after I lose enough weight, so keep me updated on your insurance situation.

Good Luck:)

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Tina, your options and rights vary considerably depending on where you live. Call your state's insurance commissioner and find out what your rights are with regard to purchasing individual or small group health insurance. Then call a health insurance broker and see if they can help. Don't try to deal with carriers directly--half the time the people talking to you have no idea of the laws that may apply.

Good luck!!

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I can only speak from my own experience, but I had no trouble getting insurance with my company's insurance. The only things were that a) they don't cover anything 'pre exsisting' for 6 months, and after that, I don't know whether they'll cover anything band related that isn't an emergency.

But do what Alex said and call the insurance commissioner. They can tell you what the rules are. ;)

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Group coverage and Individual coverage is different. I was denied individual coverage because of my weight. Thankfully, like you, my hubby is self-employed and Incorporated, so we qualify for group benefits and can't be denied. I have BCBS of NC.

The bad news is, someone on this board reported being denied coverage because she HAD the band. Do a search...or yell out if you need help finding it. I was very dissappointed to have read this. It was for an individual policy so my conclusion was that it leaves that option out for our family.

We did renew with BCBS this year, and switched to an HSA. I'm still learning about that, but I'm hoping I can use my HSA account to pay for fills. ??? I'll let you know. I don't need one just yet, so when the time comes I'll find out.

Good luck. It stinks to be too fat for coverage, get banded, lose the weight, and still no coverage. Aaarrrrggghhh!!!

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hmm that is very interesting TBM, we might have to pay the outrageous small group plans premiums that we are just to have coverage.

Is there any way to find that link? a certain search word or thread name?

For a group of 2 healthy people no pre-existing conditions (except weight gain and loss) we pay $700 per month.

Through Humana one (individual policy) my husband was paying $98 a month with our daughter on his plan!

I won't even go into what I think of the insurance industry lol they certainly aren't out for our benefit.

BCBSFL had us go through tons of testing for our son, get different opinions by "the best medical teams in FL" then diagnosed him with Autism at age 2. They sent us a "dear john" letter cancelling his coverage because of the long term care and benefits. We Appealed, talked to Ins Commissioner, appealed again - bottom line: get on the state's care for him.

So I can believe they would find a way to deny coverage if you have the band ;)

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      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.
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