Question:
Post Op problems re. buying insurance?
Hi folks: Has anyone POST OP been denied health insurance coverage? Has anyone POST OP been denied life insurance coverage? If you weren't denied, were the premiums in line with the norm or were they much higher? I have heard all of the rumors about WLS patients being denied future insurance, but need to know if this is just a rumor or credible information. I might be in a position soon where I will have to seek out and pay for health and life insurance as an individual. Please, respond if you have first hand information. Thanks in advance. Jackie — Jackie O. (posted on March 29, 2004)
March 28, 2004
When you would leave your current insurance they have to provide you a
certificate of insurability. This usually gives you 60 days to get other
insurance. The new insurance you go to has the option to exclude any
pre-existing conditions, usually for 6 months although this letter may
waive that requirements. However, many times what happens is they will not
cover any future problems or treatment they can relate to your WLS. If the
new policy does cover WLS then it might not be an issue.
<p>I ran into this at dual choice enrollment time at work. I called
one of the HMO's available to us and asked if I needed to be scoped to
check my stoma etc. would it be covered. They answered no because they do
not cover WLS anyway. I did not think that answer was right as I had WLS
under another policy my employer offered and since we are allowed to change
insurance once a year, with no pre-existing conditions applying I did not
see how they could deny me. I went to the benefits manager and explained
things and they said that yes all of their policies would have to cover any
future needs or complications related to my WLS because I had it done under
a covered policy my employer offered. My arguement was that when I would
start with that new policy this is how my body is now configured and that's
how it needs to be insured. In my case if worked out fine but not everyone
is that lucky. However, if I had the surgery and it wasn't covered by my
employer originally and then I had problems, then I would have zero
coverage for problems. This happened to a woman who went to Mexico and had
Lap Band with no insurance coverage.
<p>I cannot speak to life insurance.
— zoedogcbr
March 28, 2004
From what I understand, yes, if you have to buy your own policies (not a
group policy such as through you/spouses employer), you may have trouble.
This is the same trouble somebody with a history of cancer, heart disease,
etc. would have. There can be costly medical problems related to WLS from
true surgical complications to malabsorption issues and some insurers do
not cover those who have had WLS.
You can not be denied insurance through your employers group coverage and
if you may be losing your job, you shoulc be able to continue coverage
under that plan (at your expense) through COBRA.
Good Luck
— Carolyn M.
March 28, 2004
I was fired from my job & I lost my insurance. I applied for insurance
with Humana & Blue Cross/Blue Shield & I was denied by both. The
reason they gave me was because I had gastric bypass surgery.
I am in perfect health otherwise. I am 29 years old & now I can't get
insurance & it sucks.
— KAT *.
March 28, 2004
I understand that California is the only state that is helping with those
who are morbid obese. They are starting new centers in the behave of
morbid obese. Any one from California like to add anything? Right now it
is going to be a fight just like cancer when it first come to pass.
Unforuntely many will die and suffer.
— Tammy P.
March 29, 2004
I had know problem getting insurance. The insurance company didn't ask if I
had any former surgery. Later-Tab
— Tab F.
March 30, 2004
I spoke to at least 2 health insurance carriers about this and both said I
would be denied based on the gastric bypass. One said I would need to have
a stable weight for 2 years, and once I explained that the weight is going
down steadily, the underwriter said he would then need at least 6 months of
stability. He sounded like he didn't fully understand this surgery. So I
am basically uninsurable because of this surgery. I am able to carry COBRA
for myself, but can't afford to have the family on it too, so I applied for
a policy for them with an individual policy, while I have Cobra. It will
still cost us about $150 more a month. I just hope I can get insurance by
the time my COBRA runs out. Good luck.
— Dragonfly2B2
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