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Am I S.O.L. if I'm overweight and try to purchase my own insurance plan?



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The short story is....

I no longer have insurance through my employer and have no way to get it back right now. Which in regards to the lapband surgery, doesn't even matter anymore because my employer has a weight loss surgery exclusion written into the policy. So I can never get the surgery as long as I work for this company (Yes, I already tried to get them to waive that exclusion with no luck)

I called United Healthcare the other day and they told me my height to weight ratio disqualifies me from being able to purchase an individual healthcare plan from them. Luckily I was able to get my 7 year old daughter a plan with them or Golden Rule (that's who their individual plans are written under).

Does anyone out there happen to know some good insurance that isn't going to take my weight into consideration when trying to get a plan with them? If there are any, do you know if that certain company has a waiting period before you can make a claim for a surgery like LB?

Thanks in advance!!!

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Every medical insurance company I know of uses something like the BMI to determine eligibility, and if you're into a "morbidly obese" category or higher it's virtually impossible (from what I understand -- not saying that as a for-sure fact). The insurance companies need to think they're making a good investment, and taking on someone who is likely to immediately cost them money isn't a good investment (even if you're "healthy" the average MO person is not). heck, it may even be really hard/expensive at just "obese"... I'm not sure. Maybe call some other providers and ask.

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I knew you'd hop in here, Wheetsin...LOL! I haven't had much time in the past few days due to a death in the family, but I'm up now and can't sleep so I figured I'd come in here and try to find some direction of some sort.

That was just about what I figured. What insurance company would want to take on someone with immediate health risks. Yeah, I may not currently have any health problems related to my weight, but that doesnt mean I never will. My main issues are crackling knees, an achey back and just plain tired of looking at my lumpy butt in the mirror now. I guess I should just be considered lucky and join a gym...sigh.gif

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Very few things that I know about insurance are "for sure". But I've contracted with the industry many, many times and have seen/read/written/etc. just enough of their materials to know a few things, and have some decent guesses on others. Esp. healthcare providers. Somehow it's an area that virtually no one seems to be familiar with (on this board) so I try to help... even though it's usually not good news. :cursing:

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I applied for an individual plan through Aetna and was denied due to my BMI. My BMI was 48?!?! I was SOL! With the denial I received information on a state subsidized program here in Colorado that allowed people who would not otherwise qualify for health insurance either due to illness, loss of job or price obtain coverage. Our program is called Cover Colorado and only Colorado residents are eligible....BUT the insurance is pretty affordable and it's good insurance - it's with Pacificare PPO - they did have a 6-month preexisting condition clause. If I would not have been able to get this, I would not have been able to get ANY individual health insurance plan.

Maybe your state has a similar program?

I was also told that any WLS patient would have to be 2 years out from surgery to again be eligible to qualify for most individual health plans-given they were within "normal range" and otherwise healthy, which I thought was better than an absolute exclusion....that was what I was expecting.

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
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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.
      · 1 reply
      1. summerseeker

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

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