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Insurance doesn't cover WLS :( Now what?

Hi everyone. I posted a few days ago asking about how to start. Just got in touch with my health insurance company (Aetna) and am shocked to find out that they don't cover ANY WLS, regardless of co-morbidity. I cannot believe that. I thought we had pretty good coverage.

So what do I do now? I am seriously doubting that we can afford self-pay with 3 kids at home to consider.

Hubs said that open enrollment is in June for his company and maybe another plan his company offers does cover WLS?

So... a couple of questions for those of you with far more experience in this than me...

~If I begin a physician monitored weight loss plan now then am able to switch to a different plan that will cover the surgery in June, do you think the insurance company would accept those 6 months of monitoring for the prerequisite?

~What if hubs' company doesn't have ANY plans that cover WLS? What then?

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  • AmandaRaeLeo
    AmandaRaeLeo

    I'm a self pay headed to Mexico in March. My insurance excludes WLS too. Amanda Rae

  • Mexico or bust, baby. Mine wouldn't cover it either. I'm paying about $8750, all inclusive, for March Surgery in Mexicali. However there are good Mexico surgeons who will do it for as little as 4K

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I work at a health foods store and their insurance excludes WLS and any weight loss support. Kinda sad' date=' luckily my parents insurance covers all.[/quote']

Would that be a case of irony?

Amanda Rae

I am going to OCC in TJ, Mexico. It is an international center of excellence. I am going because even though my insurance does pay for it, I don't qualify in the United States because my BMI is still too low. I am obese baby, isn't that enough ....

Mary

Hi everyone. I posted a few days ago asking about how to start. Just got in touch with my health insurance company (Aetna) and am shocked to find out that they don't cover ANY WLS' date=' regardless of co-morbidity. I cannot believe that. I thought we had pretty good coverage.

So what do I do now? I am seriously doubting that we can afford self-pay with 3 kids at home to consider.

Hubs said that open enrollment is in June for his company and maybe another plan his company offers does cover WLS?

So... a couple of questions for those of you with far more experience in this than me...

~If I begin a physician monitored weight loss plan now then am able to switch to a different plan that will cover the surgery in June, do you think the insurance company would accept those 6 months of monitoring for the prerequisite?

~What if hubs' company doesn't have ANY plans that cover WLS? What then?[/quote']

I have Aetna and they approved my WLS within 2days. I guess it varies from company that the insurance is being sold to. I work for a big Airline and it covered up to $20,000 in medical costs. So I wish u good luck and just do ur research. If you got to Aetna website type 5011 or 1105 I can't remember the code but is going to tell you they do approve WLS.

Also go under the the tab on this application that is title Finance & Insurance. Most people with Aetna got approved. Best of luck.

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