Does Obamacare cover weight loss surgery ?

[Twinmom1311 15]

I'm in Ga and have Humana they covered mine at 100% with 6 months of failed diet and a letter of necessity from my surgeon.

[Inner Surfer Girl 12,015]

I live in Kentucky and called our Insurance commission to find out why states like Kentucky didn't include WLS surgery as a requirement under Obamacare. They said that the Affordable Care Requirements were based on what was already required by the state (existing legislation). They did imply that things were still being sorted out with the requirements although I don't know if that means things could change anytime soon. It appears that it would require legislation to make it a requirement.

Does anyone have any sample letters to use to send to our representatives?

[Alex Brecher 10,494]

I live in Kentucky and called our Insurance commission to find out why states like Kentucky didn't include WLS surgery as a requirement under Obamacare. They said that the Affordable Care Requirements were based on what was already required by the state (existing legislation). They did imply that things were still being sorted out with the requirements although I don't know if that means things could change anytime soon. It appears that it would require legislation to make it a requirement.

Does anyone have any sample letters to use to send to our representatives?

I suggest contacting the OAC. They should be able to assist you. PM me please if you have any issues connecting with them on this issue.

[angie3721 1]

Hi. I live in south Florida and have coventry one, care link with Obama care. I'm pretty sure it doesn't cover any weight loss surgery. Can anyone recommend a plan that I can purchase that will cover? Or give any info on other options?

[KDM74 186]

Why are you so against bypass? Just asking because i was also dead set on getting the sleeve. For a year and a half that is what i planned on, even through all my preop appointments. And then I met with my surgeon and he told me I had reflux and the sleeve would likely make it worse. I changed my mind and am having my bypass on Monday, purely for the fact that I am having this surgery to help, not hurt me. I was worried about having my intestines rerouted and dumping symdrome, but now I look at the positives, more research of long term outcomes, faster weight loss, and fear of dumping will help keep me accountable with my food choices. Luckily, insurance through my work covers everything and I will probably only have about $500 out of pocket. I just think that if you are able to get the surgery covered then perhaps it is time to change the way you think about bypass.

I have been researching this heavily in Arizona. So far, I have found that many of them cover bariatric surgery. Most will only cover gastric bypass. You have to read the Explanation of Benefits soooo closely. They don't specifically exclude sleeve under the topic of bariatric surgery, but then if you read further down under gastroplasty, laproscopic gastric sleeve procedure is specifically excluded. This really bothers me. They recognize it as an accepted procedure for medical necessity in treatment of obesity, but they refuse to cover that specific procedure under Obamacare. I am very, sad right now. I don't know what to do really. :/ I can't afford the cash to get the procedure, I really need it, and prefer the idea of sleeve over bypass for many reasons. I just think its really sneaky of them to try to hide that they don't cover it by not specifically stating it under the topic of bariatric surgery. :/

Why are you so against bypass? Just asking because i was also dead set on getting the sleeve. For a year and a half that is what i planned on, even through all my preop appointments. And then I met with my surgeon and he told me I had reflux and the sleeve would likely make it worse. I changed my mind and am having my bypass on Monday, purely for the fact that I am having this surgery to help, not hurt me. I was worried about having my intestines rerouted and dumping symdrome, but now I look at the positives, more research of long term outcomes, faster weight loss, and fear of dumping will help keep me accountable with my food choices. Luckily, insurance through my work covers everything and I will probably only have about $500 out of pocket. I just think that if you are able to get the surgery covered then perhaps it is time to change the way you think about bypass.

Oops, didnt mean to post twice! Phone is being weird today!

[angie3721 1]

I need to lose 100 lbs. I thought bypass would be for people who wanted to lose more than 100lbs

[KDM74 186]

Bypass doesn't have a weight limit. If it is the right surgery for you then I recommend it highly. But, the sleeve may be better for you. I certainly wouldn't exclude bypass just based on weight loss number. If you have any comorbidities like diabetes, reflux, high BP, then the bypass is the way to go. If you are healthy other than your weight, then perhaps the sleeve is best. I am day 5 post op from my bypass and I have no regrets!

[BayougirlMrsS 3,933]

@HealthyNewMe...... don't we though...... cook with carbs (stew=flour and oil), served on top of carbs (rice), with a side of carbs (potato salad).... and don't forget the bread to push it onto your fork....

how convo's go in La...... hey, it's my birthday... where we eating?..... hey, i graduated....Where we eating?..... hey, my dog died...Where we eating...

But i wouldn't live anyplace else