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

insurance question, life after banding help??



Recommended Posts

: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

Share this post


Link to post
Share on other sites

welcomebutterfly.jpg

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:)

Share this post


Link to post
Share on other sites

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!!

Share this post


Link to post
Share on other sites

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. ;)

Share this post


Link to post
Share on other sites

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!!!

Share this post


Link to post
Share on other sites

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 ;)

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

    • Teriesa

      Hi everyone, I wrote back in May about having no strength. I still get totally exhausted just walking from room to room, it’s so bad I’m using a walker with wheels of all things. I had the gastric sleeve Jan. 24th. I’m doing exactly what the programs says, except protein shakes. I have different meats and protein bars daily, including vitamins daily. I do drink my fluids as well.  I go in for IV hydration 4 days a week and feel ok just til evening.  So far as of Jan 1st I’ve dropped 76 lbs. I just want to enjoy the weight lose. Any suggestions or has anyone else gone thru this??  Doctor says just increase calorie intake, still the same. 
      · 0 replies
      1. This update has no replies.
    • Stone Art By SKL

      Decorative Wall Cladding & Panels | Stone Art By SKL
      Elevate your space with Stone Art By SKL's decorative wall claddings & panels. Explore premium designs for timeless elegance.
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Losing my hair in clumps and still dealing with "stomach" issues from gallbladder removal surgery. On the positive side I'm doing better about meeting protein and water goals and taking my vitamins, so yay? 🤷‍♀️
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      I've hit a stall 9 months out. I'm not worried, though. My fitness levels continue to improve and I have nearly accomplished my pre-surgery goal of learning to scuba dive! One dive left to complete to get my PADI card 🐠
      I was able to go for a 10K/6mile hike in the mountains two days ago just for the fun of it. In the before days, I might have attempted this, but it would have taken me 7 or 8 hours to complete and I would have been exhausted and in pain for the next two days. Taking my time with breaks for snacks and water, I was finished with my wee jaunt in only 4 hours 😎 and really got to enjoy photographing some insects, fungi, and turtles.
      · 1 reply
      1. BabySpoons

        Amazing! Congrats!!! Watch out for the sharks. 🦈

    • Mr.Kantos

      Just signed up. Feeling optimistic.
      · 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

    ×