insurance...

[zimmersdreamer]

I have just found out that the insurance that I have through my employer does not cover any weightloss surgery, nor will they add it as a rider. I need to look into getting a new/second insurence. what company is inexpencive enough that I can have long enough to have the surgery. I can have the fills i guess covered by my insurence I am not sure when or what is going on, I may decided to switch completely. I need to make the descision before the new year.

thanks in advance!

[AngieB]

I have just found out that the insurance that I have through my employer does not cover any weightloss surgery, nor will they add it as a rider. I need to look into getting a new/second insurence. what company is inexpencive enough that I can have long enough to have the surgery. I can have the fills i guess covered by my insurence I am not sure when or what is going on, I may decided to switch completely. I need to make the descision before the new year.

thanks in advance!

My insurance would not cover WLS so I paid out of my own pocket to have it. I am very little help when it comes to insurance. My insurance will not cover the fills either, but I can use money on my flex spending card to cover the expense of my fills. This year I have had 5 fills next year I only estimated I would need 3. I hope that will be the case!

Good luck in finding what you are needing!

[jhawkchick75]

Mine would cover it, but I had to work there at least three years and had only been there 1 1/2 and I was not willing to wait. I was self pay - went to the "First Bank of Dad" and am paying him back at a great interest rate! Many pull from their 401K or take out loans. OCC can also tell you about some lenders that you might look into, but those were at an insane interest rate so I did not go that route.

[PAMMIE]

I have just found out that the insurance that I have through my employer does not cover any weightloss surgery, nor will they add it as a rider. I need to look into getting a new/second insurence. what company is inexpencive enough that I can have long enough to have the surgery. I can have the fills i guess covered by my insurence I am not sure when or what is going on, I may decided to switch completely. I need to make the descision before the new year.

thanks in advance!

IN THE LONG RUN,IMO, I THINK YOUR BETTER OFF SELF PAYING IF YOU HAVE TO CHANGE INSURANCE POLICIES, IF YOUR EMPLOYER ISN'T COVERING THE COSTS, AND POSSIBLY PAY HIGHER RATES

[bogiesmom]

I have just found out that the insurance that I have through my employer does not cover any weightloss surgery, nor will they add it as a rider. I need to look into getting a new/second insurence. what company is inexpencive enough that I can have long enough to have the surgery. I can have the fills i guess covered by my insurence I am not sure when or what is going on, I may decided to switch completely. I need to make the descision before the new year.

thanks in advance!

Yep, I am in the same boat as you. Found out after my initial consultation for the band that my insurance policy with my employer specifically resticts WLS from the policy and does not include a rider. So I elected to save time and money by having the surgery at the OCC. I saved approximately 57% of the purchase price by doing so. If you do elect to switch the only type of insurance that I think would even consider covering WLS is a PPO. If your employer offers a PPO then you should have access to policy information or a customer service number where you can call and ask about WLS coverage with your employer's plan.

Like Shelby mentioned, I self paid via 3 way...1/3 savings from a serverance package, 1/3 loan from 401K, and 1/3 savings bond that I cashed in. At first I did not think I could get the money together and applied for a health care line of credit (that was quickly denied thank goodness) and then I started thinking about pooling money together from different sources. Of course now I have zero savings and that hurts a bit, but if I can hang in there for a few months I will be okay. That's the thing about self pay...buyers remorse big time

[zimmersdreamer]

sigh, I have a PPO and that was how I found out we dont have it. Bank of dad is dry and I dont have a 410k. I just started the search and info about this stuff so its not a dire need at the moment but I dont want to get too far without knowing i have a back up plan. I can save up but my mother who is a nurse warns me against surgeries from mexico...I think she is just worried about not having a DR when i am in the states should something go wrong. The reason I was looking into a new insurence is I pay about 120 a month for insurence, used it 3 times in the last year for a few Dr appointments, I thought I could either pay for a different plan through individually, or do what i used to and go without insurance for a while and save the 120 up till i can afford it. though it seems like the years I didnt have insurance was the ones I needed it most! sigh. Im already having road blocks and I have JUST begun! I may have to use income tax for the surgery, I just had plans for it already...

[AngieB]

Yep, I am in the same boat as you. Found out after my initial consultation for the band that my insurance policy with my employer specifically resticts WLS from the policy and does not include a rider. So I elected to save time and money by having the surgery at the OCC. I saved approximately 57% of the purchase price by doing so. If you do elect to switch the only type of insurance that I think would even consider covering WLS is a PPO. If your employer offers a PPO then you should have access to policy information or a customer service number where you can call and ask about WLS coverage with your employer's plan. Like Shelby mentioned, I self paid via 3 way...1/3 savings from a serverance package, 1/3 loan from 401K, and 1/3 savings bond that I cashed in. At first I did not think I could get the money together and applied for a health care line of credit (that was quickly denied thank goodness) and then I started thinking about pooling money together from different sources. Of course now I have zero savings and that hurts a bit, but if I can hang in there for a few months I will be okay. That's the thing about self pay...buyers remorse big time

Hey there. So you are unhappy with your decision on being banded...? or are unhappy with the buyers remorse with tapping so many funds? I am curious as to what make you unhappy with your choice. Do you feel like you didn't know all the facts about the band and are finding out more info after the fact. Like you made a hasty choice? From my own personal experience it was waiting for restriction that was hard to deal with.  I really didn't have restrcition that stayed until after my 4th fill.  Stayed I mean more than 2 weeks of restriction before it faded.  Ugh, for me that was hard. 

[bogiesmom]

Hey there. So you are unhappy with your decision on being banded...? or are unhappy with the buyers remorse with tapping so many funds? I am curious as to what make you unhappy with your choice. Do you feel like you didn't know all the facts about the band and are finding out more info after the fact. Like you made a hasty choice? From my own personal experience it was waiting for restriction that was hard to deal with.  I really didn't have restrcition that stayed until after my 4th fill.  Stayed I mean more than 2 weeks of restriction before it faded.  Ugh, for me that was hard. 

Unhappy about not waiting a few months before being banded. I think it was a little hastey on my part and I should have insisted on a later surgery date. I am not regretful of being banded yet since there is really nothing to regret yet since I am still wating for restriction. I think waiting another 5 months would have been best for me financially. For me, I think I sort of rushed into it and if I would have waited 5 months I would have had the time to save some additional money for the band and any unexpected emergencies that popped up recently. So I guess in a nut shell the buyers remorse comes from being financially strained and no restriction to show for it as of yet. Sounds so common sense but I just wanted to let this person know it is something they should at least take into consideration. There is nothing wrong with waiting to save up additional money if you are self pay.

[AngieB]

Unhappy about not waiting a few months before being banded. I think it was a little hastey on my part and I should have insisted on a later surgery date. I am not regretful of being banded yet since there is really nothing to regret yet since I am still wating for restriction. I think waiting another 5 months would have been best for me financially. For me, I think I sort of rushed into it and if I would have waited 5 months I would have had the time to save some additional money for the band and any unexpected emergencies that popped up recently. So I guess in a nut shell the buyers remorse comes from being financially strained and no restriction to show for it as of yet. Sounds so common sense but I just wanted to let this person know it is something they should at least take into consideration. There is nothing wrong with waiting to save up additional money if you are self pay.

I completely understand that. Matter of fact, more than I would like too. Simply I moved my surgery up 2 months due to a work issue and boy did that ever make an impact. My hubby sustained an injury that had him out of work for 6 months. During that time we had to replace his trany on his truck as well. Big financial hit. We are actually looking forward to income tax time to help us get back on track a bit. We have not been a couple who is saddled with heavy debt, so this is a new one for us. We usually plan better. It is difficult to expect the unexpected though.

It is amazing what a few months would do huh! Oh and I was all to happy to bump the date up as I was so ready to set the ball in motion. Who knew so many factors would happen over a short amount of time!?

Ugh!

[pinkfordyone]

I have been researching the Lap Band for almost 4 years now. I had a girlfriend who had it done, so I was in hot pursuit of finding out all the details. What I found out was...yes, I did qualified for the procedure, but no my insurance would not cover it. Big Bummer! It really knocked all the wind out of my sails....kind of felt like my last hope had been ripped out of my hands. I continued to think about the Lap Band through the years, went to two more doctors and checked into all the "stuff" the insurance said they would need for me to do so they could "consider" it. It was going to take over a year to do all the things they had on their list. I could have paid for it myself by the time I did everything they wanted me to do. My family doctor is actually the one who suggested that I look into Mexico. Her sister had just had it there.

My Mom & Dad also has been a big help financially and we have pulled from other areas to get the money together.

They were also very nervous about Mexico, but after showing them all the research I had done and answered all their questions, they are on board now.

Don't give up, if it doesn't come together now, there's a reason you should wait. It may not be a no, just a not now! Do your homework and don't push it. It it is the right time, everything will fall into place.

Good Luck~

[PAMMIE]

I have been researching the Lap Band for almost 4 years now. I had a girlfriend who had it done, so I was in hot pursuit of finding out all the details. What I found out was...yes, I did qualified for the procedure, but no my insurance would not cover it. Big Bummer! It really knocked all the wind out of my sails....kind of felt like my last hope had been ripped out of my hands. I continued to think about the Lap Band through the years, went to two more doctors and checked into all the "stuff" the insurance said they would need for me to do so they could "consider" it. It was going to take over a year to do all the things they had on their list. I could have paid for it myself by the time I did everything they wanted me to do. My family doctor is actually the one who suggested that I look into Mexico. Her sister had just had it there.

My Mom & Dad also has been a big help financially and we have pulled from other areas to get the money together.

They were also very nervous about Mexico, but after showing them all the research I had done and answered all their questions, they are on board now.

Don't give up, if it doesn't come together now, there's a reason you should wait. It may not be a no, just a not now! Do your homework and don't push it. It it is the right time, everything will fall into place.

Good Luck~

YOUR GETTING CLOSE YOURSELF THERE AMY, HOW YA FEELING? EXCITED?

[pinkfordyone]

I can hardly stand myself!!

[JaniceBlack]

I have just found out that the insurance that I have through my employer does not cover any weightloss surgery, nor will they add it as a rider. I need to look into getting a new/second insurence. what company is inexpencive enough that I can have long enough to have the surgery. I can have the fills i guess covered by my insurence I am not sure when or what is going on, I may decided to switch completely. I need to make the descision before the new year.

thanks in advance!

I have Kaiser and I would have to jump through hoops and wait up over a year to have it done. I worked for WAMU/CHASE and lost my job. I received a transitional pay and used it to pay for my surgery. Kaiser will not pay for the fills either since I went outside of my insurance. It was worth every minute of it. I have to find a job right away but its ok...... I have never been able to stay home either and the last few months have been driving me crazy staying home. So if anyone out there knows of any openings in the Sacramento, CA area ... please let me know.

[tootsie_lou]

I can hardly stand myself!!

Hey Amy!

We're all excited for you! You're gonna do great!

[zimmersdreamer]

Hey Amy is it? I believe that there is a reason for me waiting, yes. I am still in the "

research" phase. My insurance enrollment period is up on the first of the year (tomorrow yea!); thats the discision I needed to make. I have found some research about Indiana insurance having to include weightloss surgery if its a PPO. which ours is. So I have to look into that as well. If all else fails I will have to save up. I believe everything happends for a reason, and there is no need rushing things.

by the way congrats on your surgery being so close!!!

[Smiley]

Due to my dealings with my insurance company and my employer on some other issues this year, it is my understanding that the insurance companies are not the ones that decide whether or not the lap band will be a covered procedure, it is our employers.

Each employer/company gets to chose what groups of procedures, diseases, etc. they will cover. The insurance company may then put restrictions on it such as the 6 month doctor supervised diet, the psychiatric consult and other tests, but once these conditions are met they will cover the procedure if it is on your employer/companies list of covered procedures.

[bogiesmom]

Due to my dealings with my insurance company and my employer on some other issues this year, it is my understanding that the insurance companies are not the ones that decide whether or not the lap band will be a covered procedure, it is our employers.

Each employer/company gets to chose what groups of procedures, diseases, etc. they will cover. The insurance company may then put restrictions on it such as the 6 month doctor supervised diet, the psychiatric consult and other tests, but once these conditions are met they will cover the procedure if it is on your employer/companies list of covered procedures.

Absolutely, that has been my understanding of it as well. The employer is the one paying for the policy. They get to pick and choose what benefits are included and which ones they would like to opt out of.