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Need some help...

My insurance is with UHC under Office of Group Benefits (Louisiana). There is an exclusion on my policy that will not allow me to have the surgery.

Aside from becoming a self-pay, is there an insurance company I can purchase a policy from (rather than using employer carrier) that will cover this procedure?

I am so disappointed that my insurance won't cover it.

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I can't say why, but I don't think it works that way. Laws of some kind or another. And I could be completely wrong.

Portability would also probably be a challenge for you.

And I'm not sure you'd save anything being self pay vs. individual coverage.

As long as you keep your Employer based coverage, you won't have any issues with portability. The problem with getting an individual plan is that the laws for individual health insurance allow the insurance company to set their rates according to your health risks. For people in our situation, that means that the rates are going to be high.

Also, individual insurance companies are allowed to impose exclusions for pre-existing conditions. If they do this, you would be paying a large premium for the individual insurance along with the premiums you are paying for your 2 employer based plans. And after all that, the individual plan could probably deny coverage for weight loss surgery due to the pre-existing condition.

Yuck...

My insurance is with UHC under Office of Group Benefits (Louisiana). There is an exclusion on my policy that will not allow me to have the surgery.

Aside from becoming a self-pay, is there an insurance company I can purchase a policy from (rather than using employer carrier) that will cover this procedure?

I am so disappointed that my insurance won't cover it.

I am also in Louisiana and have an exclusion in my policy that will not pay. I called State Farm to see about getting a supplemental health insurance policy that would cover the surgery. Wow...it is very expensive with a high deductible. The bottom line is that I will have to be self pay. My doctor charges about $15,000 with a year of aftercare included. The supplemental insurance would have had a $5000 deductible plus I would have paid 30% of the cost of the surgery. Sounds like less? It is not; because the charge for insurance companies is not $15,000, it is something like $40,000...so my out of pocket would be more than $15000, not to mention the premiums and the fills and appointments for the first year.

I'm looking into some finance options. In fact, I used to work for the state and still have some money in Lasers that I will draw out and use for a portion of my surgery.

Good luck to you.

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