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Insurance exclusion

I called my insurance company after chatting with my DR to see about a gastric surgery. I was told it was a specific exclusion in my policy...not even if deemed medically necessary. So, am I out of luck for any coverage?

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I'm sure your Dr.'s insurance department can give you more information, but it does sound like your plan doesn't cover the surgery. :(

I called my insurance company after chatting with my DR to see about a gastric surgery. I was told it was a specific exclusion in my policy...not even if deemed medically necessary. So, am I out of luck for any coverage?

Sent from my SM-G920V using the BariatricPal App

Yes, unfortunately your out of luck. My employer policy has exclusion for wls and plastic surgery no matter the reason. Your only option is cash pay in the states or Mexico or some surgeon's will do it at a reduced rate if you have a Hernia that is covered by insurance.

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A friend of mine had a policy that did not cover W LS so she changed insurance policies. She's willing to pay a little more in co-pays to have insurance that covers what she needs.

HW - 283

SW- 238

CW- ?

Not every employer plan excluded Bariatric surgery. One of my friends that is just starting the process has it covered through her husband's work insurance. Employers can separately choose to exclude it from the coverage they offer you.

HW - 283

SW- 238

CW- ?

Edited by Chicken Lady

  • Author

All work policies exclude this.

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Why do they exclude ? Changing plans ?

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It keeps the cost of our insurance down.

  • Author
chicken Lady" data-cite="Chicken Lady" data-ipsquote-timestamp="1478323259">

Not every employer plan excluded Bariatric surgery. One of my friends that is just starting the process has it covered through her husband's work insurance. Employers can separately choose to exclude it from the coverage they offer you.

HW - 283

SW- 238

CW- ?

Sorry, I meant to say MY insurance...all levels offered, exclude and bariatric surgery and weight loss programs. What adds insult to injury is that since my company was been bought out, 3 years ago, I started to work even longer hours, stopped working out regularly, resulting in gaining 65lbs over that time......and then they dont cover anything to help reverse the damage.

Luckily, things have been settling more and I am back to trying to regain my life. I was obese before being bought out...but this just made it worse.

All work policies exclude this.

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Absolutely not true. My policy through work covered my VSG in 2014 and my current policy covered my revision to RNY in July which was needed due to severe GERD. So your statement is 100% false.

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  • Author

All work policies exclude this.

Sent from my SM-G920V using the BariatricPal App

Absolutely not true. My policy through work covered my VSG in 2014 and my current policy covered my revision to RNY in July which was needed due to severe GERD. So your statement is 100% false.

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Please understand that the word "MY" was missing from the post. All policies MY work offers has it excluded.

Sent from my SM-G920V using the BariatricPal App

Some employers will exclude if they have the option but it is my understanding so states don't allow for the exclusion.

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