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Anyone had gastric bypass covered by ins?

Posted: Jan 10, 2011

I work for a company who had great insurance that I was in the process of signing up for and cancelling my old insurance, when I get an email saying they are changing insurance. The new insurance is expensive and weight loss surgery is always an exclusion (though deemed medically necessary by my physician). I was crushed because I thought I was finally going to be able to have surgery. Has anyone had this surgery and if so, what company do you work for and who is the insurance though? Is it very expensive? Please email if you are uncomfortable posting this. I'd appreciate any input you can give me. Thank you!!

;

I have never had the surgery, but - cindy

[ In Reply To ..]
have typed notes on patients who need a joint replacement and need to lose weight first. My understanding is that you need to try all the conservative treatments first, like a weight management doctor, dietician, exercise or unable to exercise, etc. and have failed at those first. I was under the impression that if you are morbidly obese and failed conservative methods that your insurance company had to cover this. You can check your body mass index by googling BMI and they usually have a calculator to figure this out from your weight and height.

Thanks for your reply - Obese

[ In Reply To ..]
It is true that conservative measures have to be met first, as well as certain BMI, health risks, etc. I have been on this path for 15 years. My physician agrees that it's time to do something more definitive. I met all the requirements for the old insurance but since that's been cancelled, I'm up the creek, as it were. Trust me, I've done my research.

Maybe this will help - Good Luck

[ In Reply To ..]

You probably already checked this out, but just in case, I found it kind of interesting. Maybe once you find an insurance company that covers the procedure, you can ask on one of the Boards here which MTSOs offer that insurance.

I only know of one MT who had the procedure done (which was probably 5 years ago now) and not even sure she went through the company insurance, but she worked for Axolotl, for whatever that is worth. They may not even carry the same insurance today, but an Email to the Human Resources Department may get you an answer as to if their insurance still covers it.

Good luck to you. I truly hope you are able to find a company to cover you. I have since lost contact with this lady, but after the surgery, she was very open about having the procedure done and said she was really glad she finally did it.

http://www.obeseinfo.com/insurance_gastric_bypass_surgery.htm

Gastric bypass- sm - I checked into....

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lap band about 2 years ago. At the time I had Aetna PPO and they did cover it, if it was deemed medically necessary. Most of the docs/centers that do the surgery know exactly how to get your ins. to pay for it, if it is covered. Aetna required that you attend 6 months of counseling before the surgery. The 6 months had to be consecutive so if you missed a session you had to start all over again. I was told at that time that Blue Cross PPO did not have that requirement. Just something for you to check into.

I know two ladies who are best of friends that decided to have it done together. The did the surgery the same day, were in recovery side by side. This is what I noticed --- One looks fantastic, the one with the least amount to lose but still over 100 lbs. The other one, four years later still looks obese. I have been out to eat with both of them and there is something to be said about the counseling. The one that hasn't done that well has not changed her eating habits. She eats fattening foods and almost always orders desert. What she can't eat, she takes home to "eat later". It has a great success rate but it still isn't a magic cure unless you change the way you eat.

I have a cousin who did gastric bypass and she did great. I have a friend that is an RN and lives in Mexico and she had the gastric sleeve procedure and she did fantastic.

I worked with an RN that had gastric bypass and had Starbucks and a huge pastry in her hand every morning when she came into the office. Lunch was patty melts, cheeseburgers, grilled cheese. Afternoon snack was an ice cream bar every afternoon. People said she was a lot heavier before I started working there but she was still way, way over weight.

Good Luck I hope you have success.

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