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Stinkin Exclusion....



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My policy through my employer also had an exclusion. I went outside of the employer plan and purchased an individual plan on my own through BCBS who covers Bariatric surgery without any problems. My monthly co pay was about $100 more a month but well worth it. Going this route I was able to not touch my 401k or take a high interest loan. In about six months when my company has open enrollment again and post surgery I'll jump back on their plan for lower rates.

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I was effective 1/1/14 with new BCBS and approved for surgery 1/14. Surgery date is 2/10. Not bad timing and no questions asked with my new individual plan. It went smooth as a babies butt.

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Which BCBS you purchased?

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I'm in the same boat- EXCLUDED!!!! I'm so bummed. My surgeon charges right under $9,000 for the entire procedure, hospital stay, pre-post visits, etc. I have NO idea how to finance this. I have nothing to offer as leverage.

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I would def look into getting a policy that includes bariatric surgery. I know that BCBS does.

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Exclusions totally suck! My daughter went through this with Aetna about a year ago. Open enrollment we switched to my husbands plan which is UHC anddddddd I've jumped on board to have VSG as well. Far less stringent then Aetna and I was approved within 3 days of submission to UHC for approval.

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Exclusions totally suck! My daughter went through this with Aetna about a year ago. Open enrollment we switched to my husbands plan which is UHC anddddddd I've jumped on board to have VSG as well. Far less stringent then Aetna and I was approved within 3 days of submission to UHC for approval.

Aetna most certainly approved bariatric surgery. It's your employers contract that would cause the exclusion

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What private plans cover bariatric surgery?? That's where I'll be shopping for new insurance!

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Make sure to check the benefits covered. I just applied and I'm waiting to hear from them.

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What private plans cover bariatric surgery?? That's where I'll be shopping for new insurance!

I know some bcbs does cover..it usually has a higher premium though. Bcbs has faster approvals,especially if your bmi is over 40.

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You know Aetna, united and Cigna all customize their plans for the specific employer. So it's your employer who is refusing.

Couple options

Get on hubby plan if possible

Go on the healthcare.gov pick up a plan temporarily for yourself for a year. Get the surgery and drop it. It may be cheaper than a loan nj the long run

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Self pay insurance is the best way to go. I have B/CB/S of MI ppo. My premium is $200.00 a month with a $300.00 deductible, my out of pocket is $1200.00. It's the best way to go!

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Self pay insurance is the best way to go. I have B/CB/S of MI ppo. My premium is $200.00 a month with a $300.00 deductible, my out of pocket is $1200.00. It's the best way to go!

Wow nice I have $1000 deductible and $2500 total out of packet.

How fast were you approved?

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I haven't been approved yet. I need a phych evaluation. I'm sure I will get approved I just need to stop smoking. I have acute reacquiring pancreatitis. I don't drink it is food that does it.

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
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    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
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      1. This update has no replies.
    • bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
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