Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Anyone use 2 health care plans?



Recommended Posts

While I'm waiting on the insurance coordinator to give me a call from the surgery center...thought I'll get some input here. All my testing is complete except 3/6 month supervised weight loss program but my 2016 work insurance omit bariatric surgery BCBS. I found a plan through the market place UHC that would work. Have anyone used two insurance the Coinsurance is 0% after met $3600 deductible...oh how do I add a pic to my profile?

Edited by nicole91379

Share this post


Link to post
Share on other sites

FOLLOWING! This happened to me. WLS was covered under our plan in 2015, not in 2016, and I have done everything required but meet the surgeon and do the psych eval. So bummed!

I was told I can buy a BCBS policy on the exchange up to 1/31/16 (cutoff on Obama enrollment) and self-pay for a policy. My friend who does medical billing said buy the spare policy 1-2 months before surgery and keep it up to 6 months after surgery to cover the post-op Dr. visits.

Also, she said any complications from WLS (gallbladder surgery, hernia repair, strictures,) would not be covered under your original policy -- it's viewed like plastic surgery -- optional, and any complications would need to be billed under the WLS policy you are buying. It's getting complicated!

I'm a 1099, so BCBS said I can buy any time, not limited to the 1/31/16 deadline, and WLS is covered.

Now, the other issues are choosing plans. I'm going with a high monthly premium and $1000 surgery copay after meeting my $2000 deductible, not the 80/20 plans or 70/30 plans, where I'd be responsible for 20-30% of a $30K surgery.

I'm interested in any advice/experience anyone has. I was devastated last Friday when I looked over the new insurance package and saw bariatric isn't covered anymore! Sucks.

Share this post


Link to post
Share on other sites

Are you covered under a spouse's insurance?. I have a family plan with my employer includes myself and 3 children. I'm so frustrated with all of this.

Edited by nicole91379

Share this post


Link to post
Share on other sites

Sorry for the delay, as you can imagine with Christmas, it's hectic!

Yes, we are covered under my husband's BCBS insurance which, ironically, I was SUPER excited to get with his new job as it blows away the shitty, basically catastrophic insurance we had before -- only to find the BCBS plan they are offering dropped WLS as a benefit.

This is SUCH a PITA and disheartening. I'm already taking a non paid hit when I have the surgery since I'm self-employed and don't get any paid time off, and paying for an extra policy -- on top of a stellar policy that is finally provided to us -- GAH!!!!!!!!!

Share this post


Link to post
Share on other sites

I had aetna as primary from my employer and caresource through the state as a secondary and I didn't have any out of pocket expense...

Share this post


Link to post
Share on other sites

My mother has both Medicaid and Medicare.

Share this post


Link to post
Share on other sites

Be careful with this. In some cases the primary insurance doesn't cover bariatric then the secondary won't either.

Sent from my SM-G900R4 using the BariatricPal App

Share this post


Link to post
Share on other sites

I have BCBS through my employer that covers WLS, and then I am also covered under my spouse's insurance that covers WLS as well. He is a retired federal employee with AMAZING insurance. The only thing I will have to pay out of pocket is the $300 'program fee' for consults with the physical therapist, nutritionist, etc. that insurance doesn't cover. I should have done this years ago!

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 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. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • 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
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×