Weight Loss Surgery - Question about insurance ...




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VeggyMom
12-03-2005, 09:30 AM
My insurance policy specifically excludes all obesity treatment (even appetite suppressant meds) including surgery - so since I have the means to pay for the surgery myself that is what I am planning to do.

But one thing that occurred to me ... if you have an elective procedure that is not covered by your health insurance policy and there are complications, is treatment of the complications covered?

I know that this is a question that I will have to ask of my insurance carrier on Monday (or maybe next week since I'll be at Disney World on Monday). But I was wondering if by chance anyone had any thoughts on this?

Of course I hope and pray that I won't have any serious post-op complications but you never know.

Carole


kykaree
12-07-2005, 12:10 PM
I work for a large health insurance firm in the UK. Obesity treatment is excluded on all our policies. If you went ahead and had the surgery and there were complications, you would not be covered on our insurance policy. It well may be different in the US, but probably not. Worth asking them the question, and I would be inclined to ask it in writing rather than phone them, coz then you'll get your answer in writing, always handy to have!

indigo child
12-07-2005, 12:55 PM
To me, this is discrimination at its finest, and should not be allowed in the World According To Indigo Child.


DancingAngel
12-07-2005, 01:43 PM
Hmmmmmm -- so do insurance companies cover treatment for alcohol or drug addiction? If they don't, at least they are being consistant. If they do, what is the difference between those self-destructive behaviors and overeating? All cause an abundance of health problems over time.

If I am speeding and cause a traffic accident in which I am badly injured, does my auto and/or health insurance cover my injuries? I think so... If i suffer permanant injuries causing future health impairment, won't my policy continue to pay to the limits of my coverage? And yet it was my choice to exceed the speed limit!

Where is the difference? Just wondering...

JustPeachie
12-07-2005, 03:03 PM
I work for an HMO here in Florida.. and If you have an elective surgical procedure. and something goes wrong. .and its realted to a non covered benefit.. then nope they will not cover it.. Now our insurance company will pay for some groups if its medically necessary and with medical clinicals form the surgeon and the reivew of our medical directors. they decided. then the member can appeal if its denied... It a huge mess at times. but I see them get approved. However; they didnt approve mine.. as its not a covered benefit for our employee group.. go figure... I went thru a group and I know they have this group in all states. Vocational Rehab.. they paid for surgical procedure, and all followups until the dr releases me which wont be until about this time next year.. and pays for all my meds.. if your insurance wont cover it and your planning on paying out of pocket.. then look up your local vocational Rehab in your county or one close by .. and go in and tell them you need assistance wityou your disability.. tell them its obesity.. thats what i did .. They had me do a fiew things.. but they paid for all of it.. the psych eval .. and all appts.. Its worth a try. its something to think about any ways. if you need help to find one in your area. message me ill see what I can find..
Now for the auot thing.. Ill tell you what we do.. If it an auto accident.. we in Florida are a no fault states. and they first 10,000 is paid by auto insurance. if then that is exhausted. then we will continue to pay for any injuries due to that accident.. I think thats how most of them work. any how.. thats how the company I work for works.. toodles for now..

VeggyMom
12-10-2005, 11:54 AM
Thanks everyone. Sorry I didn't thank you earlier, but I just got home from Disney.

And Peachy - thanks for your advice. I'll look into that.

I'll be honest - the cost of the surgery isn't prohibitive for me. I can easily afford it. My biggest concern is if there is a complication it could ruin us financially. Though that is the same risk I would take having a breast enhancement (or reduction) or a face lift ... and I don't think I'd be as worried if I was having one of those sugeries.

So much to think about ... the mind reels.