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Dr. Kelly as a back up plan...but what do I do when i get back?

Dualstarr

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Dualstarr    104

Dualstarr
Posted

I currently have Kaiser as my insurance and am about to start the Options class in order to have the surgery done. Problem is, I am also in the process of a divorce and on my soon to be ex-husbands insurance. I am hoping I can complete the class and the surgery before our divorce is final and insurance runs out. I am thinking I have a good 6-8 months (fingers crossed before everything gets squared away. Our divorce process has taken over a year and a half and I am KICKING myself that I didn't start this process sooner. My insurance covers the sleeve 100% with no c-pay. Would not have cost me a dime! :(

Anyways, if the insurance runs out before the surgery, i have money saved to go to Mexico (Dr. Kelly) and have the surgery done. My question is, When my insurance runs out I will only have state funded medical insurance (Medi-Cal..I'm in California) until I find a job (Nursing School Graduate). My worry is that if I have the surgery in Mexico and then try to get coverage in the states with insurance it will be considered a Pre-Existing condition and no insurance will take me?

For those of you that went to Mexico. has your insurance covered anything pertaining to your sleeve...ie compliction, medications etc.

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MizzouGirl    148

MizzouGirl
Posted

Just take COBRA under your husband's insurance for as long as you need. Or, ask for him to cover you for 12 months as part of the divorce settlement. Just a couple ideas that you may not have considered....

losingit2013 reacted to this

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Bufflehead    6,358

Bufflehead
Posted

If you can make it to Jan. 2014, the Affordable Care Act kicks in and insurance companies will be prohibited from denying you coverage or charging you a higher rate due to a pre-existing condition.

dork, Kristen125 and losingit2013 reacted to this

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serenity1959    67

serenity1959
Posted

I have not had my surgery yet, but my insurance absolutely excludes anything related to my weight loss surgery. I am going to purchase complication insurance.

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Ms.AntiBand    2,984

Ms.AntiBand
Posted

I pay $750 a month for insurance and my employers pays another $750 for us and they refuse to cover ANYTHING related to wls even if you're on your death bed. I'm out $100,000 because of band related complications. Nothing I can do. I'm still not cover if anything goes wrong with the sleeve.. BUT THERE WON'T BE ANY!

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Dualstarr    104

Dualstarr
Posted

Just take COBRA under your husband's insurance for as long as you need. Or, ask for him to cover you for 12 months as part of the divorce settlement. Just a couple ideas that you may not have considered....

I don't think this is an option. My husbands insurance is paid 100% by his employer we pay zero co-pays for anything...I mean NOTHING. I don't think cobra is an option...and if it is it would probably be CRAZY expensive. I will talk to my lawyer about seeing If I can get him to keep me on but in all honesty I don't think that will be an option either.

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Dualstarr    104

Dualstarr
Posted

If you can make it to Jan. 2014, the Affordable Care Act kicks in and insurance companies will be prohibited from denying you coverage or charging you a higher rate due to a pre-existing condition.

Do you have any more information on how this works? are pre-existing conditions only an issue with self-pay insurance? For example if I get insurance under a job do pre-existing conditions still matter?

guate_mama05 reacted to this

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Bufflehead    6,358

Bufflehead
Posted

It looks to me like it applies to all insurance policies. http://www.whitehouse.gov/sites/default/files/uploads/careact.pdf

"Starting in 2014, the Affordable Care Act will prohibit health insurers from charging more or denying coverage to people because of pre-existing conditions."

It doesn't say this is just for individual plans purchased from the exchange so I assume it applies to all insurance plans.

All this said, I guess insurance companies might be able to do something like put a clause in their policy excluding coverage for complications for elective surgeries or something like that? That would probably require a lot more research to figure out though!

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losingit2013    48

losingit2013
Posted

Do you have any more information on how this works? are pre-existing conditions only an issue with self-pay insurance? For example if I get insurance under a job do pre-existing conditions still matter?

Employer sponsored plans do not ask about pre-existing conditions.

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rhw94123    115

rhw94123
Posted

This is very late, and I have to wait until I get the actual policy in hand, but the word I have on Blue Cross ACA exchange policies in my state is that they will not cover surgery, weight loss drugs or exercise instruction, but they WILL cover three nutritional counseling sessions a year and reversals of (or revisions to) previous WLS if that would correct a life-threatening condition. I have not been able to sign up for an actual policy yet because the system is so slow, but I will report back when I do and I receive the thick booklet in the mail.

Best wishes.

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