Since we are self employed we do not have health insurance. We are looking into getting it soon though. One of the cheaper and decent plans was unicare. When calling and asking about private pay insurance , Do you ask them outrigh" Do you cover for WLS banding surgery " Or do you ask them " Do you have any EXCLUSIONS" I guess what im asking is HOW Do I find out about it. Also someone said that since its self pay I could get the policy to COVER It since im private pay . How would I go about doing that ?

Any suggestions ? Ive come to the conclusion prior to this that I was going to be self pay . But have been looking and saw that Unicare apparantly seems pretty good about covering the band. So if they Do great, if they dont we need health insurance anyway .

Thanks

Mindy

Hello. I had my surgery about 2 months ago and it was covered by my insurance. Since then I have left my job and I was looking for private insurance but I am being denied because of the band! It's crazy because I can't find anyone to insure me. I was told the only way I could be insured is on a group policy. So, because i have the band I will be forced to work for someone else so i can get on group insurance? I am so frusturated that I did not find out about this before.

I would get the cpt codes for the surgery and fills (available online) and ask that way...

My employer's policy is with Unicare and they did pay for my band. But I think there are different policies with different employers. I think you just need to ask.

If you're purchasing non-group coverage, I think you'll have trouble in any case, because companies don't like to insure people who are morbidly obese to begin with. They'll also decline you for most of the co-morbidities, like sleep apnea and hypertension. Then they'll still decline you if you've had the lap band surgery, though I'm not sure why. (Maybe they think you'll regain?) To put it bluntly, you're screwed any way you go.

You want to have a group policy with a large enough group that they don't individually underwrite. Usually, that's over 50 people.

Most states have a high risk pool that will cover uninsurable people like us, though at a very high cost. Another option that may not help you is COBRA after leaving a group plan. In any case, you have to make sure you get the insurance within 60 days of leaving a group policy, or they're allowed to have pre-existing condition exclusions.