Page 2 of comments on Gastric Bypass Surgery - Will Insurance Cover the Cost?
by Craig Big-T Thompson
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Stop gloating Canadian- you might get a sudden influx of obese Americans in your hometown. Put that in your pipe and smoke it, eh?
United Health Care - Choice Plus covers this. However, it isn't just about the insurance company. It is also about the employer. The employer who chooses the plan also may pay some of the cost. UHC - Choice Plus based upon our insurance will cover 100% for the whole procedure, on in-network. They will also pay 100% for specialists (including Nutritionist) and surgeons. On the Psychologist for the Psych Eval one must pay only the $15 co-pay per visit. For any regular physician appointments it is just the $15 co-pay per visit. For any prescriptions it is your standard prescription rate. The requirements under this plan are that it has to be a medical necessity.
I want to reach out to everyone that has left a comment here. I am trying to get enough people to assist me in pressing our government to pressure insurance companies to revise their treatment of obesity. I would like to see gastric bypass and lap band surgeries to be considered preventive methods.Preventive because once the surgery is completed most health issues such as hypertension, heart disease, high blood pressure, heart attacks all decrease as a result of the weight loss. The long term benefits would be less expense to the health insurance companies because obese persons would not need the prior medication, they would not need to be hospitalized due to weight related illness, they would be healthier therefore they would not have to visit the doctor as often. If more health insurance companies would support weight loss surgeries, the percentages of death caused by obesity would decrease. We all know that being heavy contributed to higher risks of death at early ages as well as health problems that become persistent and lifelong. With the pressure of so many people and support of our government and state officials, we can get this goal accomplished.
I am looking into having gastric bypass done in Mobile,Al and my Medicare Complete covers it as long as it is life-threatening,which at 6'2" and 471 and most of the co-morbid conditions mine is definitely that.My doctor also mentioned when he interviewed me that BC/BS of Alabama covers it too.The wait and amount depending on your level of coverage.why won't bluecross/blueshield cover it in ohio?
Everyone needs to understand that you can fight any insurance company you just have to hang in there and keep appealing, finding a good Bariatric Surgeon to help you with the filing processes and appeals is best but you can do it on your own. Whenever a procedure is submitted for approval unless it is a common procedure or a life threatening condition the first response from the Insurance Carrier is almost always a denial and a large percentage is denied after the 1st appeal but go back after them again. My husband and I had to fight for 13 months, in that time we had to appeal the decision 2 times along with keeping up with monthly visits to the Dr to track his weight and other conditions. We also made sure my husband saw specialists for every condition he had almost monthly. My husband had many medical conditions that made the surgery a medical necessity and over those 13 months the insurance company could see the cost of his conditions. My last conversation with the insurance company consisted of this comment - you will pay for chemotherapy to give a terminally ill cancer patient 6 more months of life but you won't pay for bariatric surgery to give someone the chance at years of extended life. I'm not saying you shouldn't pay for Chemotherapy but I am saying Obesity is a disease and why shouldn't my husband have a chance at life too. Insurance companies know that most Obese people have been told so often that if they weren't obese they wouldn't have so many medical problems. They are sent home with a prescription to lose weight and it will go away, so not wanting to hear this so often obese people just quit going to the Dr unless the illness or condition becomes to much to handle. My husband was approvied in Feb 08 and now 8 months later he has lost 126 lbs and ALL of his medical conditions have vanished. The fight is worth it no matter how long it takes. And those of you who can afford it if you are denied over and over again, especially if you have a lot of co-morbid conditions - Sue the insurance company for causing you undue harm and indangering your life and make sure there is BIG media coverage. I would imagine there are plenty of attorney's out there who would take this type of case for free. We can lobby our government as much as we want to get insurance reform and I think eventually it will happen - but meanwhile we shouldn't stand by and watch our loved ones die over something that is preventable. Good luck to everyone and keep on trying!
I want to know straight up if medicaid does cover the GB surgery?I have read old and new posts all over the internet about medicaid and medicare does cover the surgery and does not cover the surgery,which one is it ??????????????????????????????????????????I have been battling my over weight for the past 23 years. It was like in my younger years my weight was never a issue. Later in life I found out that I would have to be a single parent and that my parents would divorce and when this took place my weight problems began and all hell broke loose. Yo yo dieting for the last 23 years is no joke and it is very very dangerous. It has truly taken a toll on my body and to this day I am paying the consequences for it. I feel that I am fighting for my life now and I am running out of time and options. I don't know what else to do at this point and I am very tired.I read on this post that the GB surgery can be done for "FREE" in Canada. Where in the world is this done at ? When someone finds out don't be stingy let me know :0)
Hey guys,I was able to check if my insurance covered gastric bypass on obesitycoverage. I'm not sure how accurate it is but it was correct about bcbs covering mine.Hope that helps.
I do not think that Medicaid should cover the cost of this type of surgery. That is a program funded by other tax payers money. I would never ask other taxpayers to be responsible for such a surgery on my behalf.I'm a single parent of two children. I had no help from the children's father with insurance and when it came to a certain point, medicaid turned us away for health coverage, then we had none. Now that is just crazy. Then I read posts here where folks want medicaid to cover their cost for this? Sorry, find another way. I don't mean to be rude but I'm a hard working single parent that they wouldn't help and I will not have my tax money used for this.Find another way to get it covered please. Get into a health and fitness program, take better care of yourselves, eat helathier, do whatever you need to but don't expect others to handle this one. And let me tell you, I had thyroid cancer and the part of the bill that I didn't have covered by insurance is due and owing. Guess how they get the balance if I can't get it all paid? They take my state tax refund, which is fine, that's me paying my bill, not somebody else. I'm proud to pay my own bill somehow.It's time we all start taking responsibility for our own actions, health and well being.It's things like this that has our economy so messed up. If this is where my tax money is going to go it's crazy!I'm sorry, but I have worked and paid into Social Security & Medicare for years. I expect Medicare to pay for the operation now that I am at 65 years old and struggling to live another 20 years. I have never said anything about the illegal alien programs or the single parent programs that the government sponsorers. So, please don't try the bleeding heart therory, at least I have paid into my programs to the max every year.amen to that.. i worked two jobs all my life and paid in alot into the medicare program and now that i am relying it to come to bat for me i am going to take advantage of MY money being spent on me..medidaid the last time i checked is a government funded program that is why it varies from state to state. it does not say anywhere on your check stub that you paid any medicaid taxes for those on medicaid to use. so do your research before you give us a bleeding heart story. i worked hard long hours and paid for it by having a heart attack at the age of 49. the meds they have me on caused a huge increase in my weight...so i am having the surgery to correct all the problems the medications caused and for my heart as well.. it i go to bed with a clear consious every night.Melissa, you must be skinny.Medicaid or Medi-cal does not denie anyone services if you complete all of the paper work they do on the other make working parents such as myself pay an out of pocket copay of $1500.00 per year before they cover any cost and I feel that most people who receive medical from the government are working they just cannot afford the monthly cost of insuranceyeah you are a little high and mighty there sister. Where do you think your big tax refund comes from???earned income credit...That would be my tax dollars paying for you to breed. I think that everyone should be a little more understanding and a lot less judgmental when thinking about others' health issues. You have no idea why someone is overweight or why they are having difficulty losing or maintaining weight loss. Please try to be a little more open minded and sensitive.i'm sorry melissa, but i completely disagree with you!! i have paid in to the government for 14 years...why should i not be able to get this paid for by insurance when I have been down on my luck? Its not like i'm just sitting around being lazy...i have always worked, even when i was 16 and my dad didn't want me to work, i snuck a job. I have paid a decent amount of money over 14 years and think this should be available to me. i'm sorry that the state did not help you when you needed it, but thats no reason to wish other people to not get healthcare!! and as someone else said, i hope you never have anyone in your family that needs this kind of surgery, because you wouldn't understand it.
Melissa ... wouldn't you want less tax dollars spent on Gastric BP than triple or more on all those other weight related health problems ... which can be endless. Your argument doesn't hold water. A logical argument could be ... you're against Medicaid in general. If your concern is with your tax dollars being poorly spent then you surely would support gastric bypass ... the more economical of the two.Another argument could be ... it may be the right thing to do ... eleviating human suffering as obese people do suffer.
Way.. too often obese people are blamed.. But you would never blame a cancer patient.. heart patient.. young baby born with a low birth rate in an ER with all types of problems...And what makes you think anyone wants to pay for insurance for your children? Why should they be any more important than someone that needs WLS? Do they have more rights?I'm 52.. worked all my life paying taxes, put myself through college and raised three children on my own. You haven't paid a dime for me.. and won't.. but I think you are very uneducated and inimformed regarding this subject or weight problems and WLS. Society as a whole is becoming obese and the government needs to find a way to proactively address this problem in the best cost effective way. Just saying "NO." Isn't working...WLS is recommended by doctors in many cases and these people deserve a chance at life just as a cancer patient does or that small baby in ER.
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