Need Your Expertise

[KabinKitty 10]

I have Anthem BC/BS (Blue Access) which we all know is NOT currently covering most VGS's. Hubby and I are both on MY policy. I found out today HIS company's ins. is Aetna.

If we both sign up for his ins. would I be covered for my surgery? I didn't know if I would be considered pre-exsisting if I went for my surgical consult on the 17th of June.

I haven't done anything else as far as seeking treatment or anything with any other doctor for any WLS.

[Tiffykins 672]

Not all Aetna plans cover VSG. If it's an employer's policy, the employer/company can opt out of bariatric surgery coverage. With that said, I would check the policy specifics before switching insurance policies.

It should not be considered pre-existing condition, but again you'll have to check the specifics of the policy.

[KabinKitty 10]

Thanks for you ideas Tiffykins..you're such a sweetie!

Hubby said that he knows of at least one lady where he works that had WLS. Also, I would NOT give up my ins. NO WAY, NO HOW! It's a great policy! If we would make a change we would get the family plan under hubbys plan. I know we would be double covered, but it's better than paying out of pocket I guess.

Anyone know if Aetna is covering VSG yet?

[Cancel 1]

Most insurance companies will waive the preexisting if you can prove you didn't have a lapse in insurance coverage. You will just need a letter from BCBS stating when your insurance terminated.

I went from my employers insurance to my husbands last year. one terminated on Dec 31st and the other picked up Jan 1.

Hubby has Cigna and I am so excited because while I am still going through their 6 months diet they now cover the Sleeve and It's what I wanted. :thumbup1:

Also, I agree with above. Call to make sure that the employer covers WLS.

[WeekendWarrior 0]

Some employers have an open enrollment period where you can change insurance coverage and avoid any pre-existing conditions.

Some states also exclude any pre existing conditions as long as you have continually been covered by health insurance.

[avilda 2]

Yes, Aetna is covering vsg... they are covering mine next week. Be sure to make sure it isn't an exclusion on your husband's policy.

[Lillie24 2]

I am an insurance specialist and I agree that Aetna is covering VSG BUT.... every plan out there pretty much is.. it's a matter of the options in coverage that the employer has selected. So if your husbands employer updated the Aetna package on Jan 1st of this year, it could be that they no longer op to cover bariatric surgery. I would call the human resoarces department for your husbands employer and ask them. While your asking them if it is a covered benefit also ask them if there is requirements that have to be met. For example, my company made it mandatory that the employee was employeed with the company and held insurance with the company for 2 years. And it was 2 years anniversary from your 90 day mark. This insured that people did not jump around with insurance coverage. They also had a 6 month supervised diet requirement. Until 4.1.10 they only covered the Lap band and not VSG. *I'm happy they updated that one*. So you see... it really does weigh heavy on the employers decision.

Hope this helps.