How can I get my health Ins. to cover the lap-band surgery, that they say isnt covered on my plan?
929454
This covers your insurance...\nhttp://www.obesityhelp.com/morbidobesity/members/list-insurers.php?State=FL&alphaPos=B\nYou should be covered!\nDo your research!\n\nGastric bypass: Is this weight-loss surgery for you?\nAre you a candidate for gastric bypass surgery? Find out what to expect and the benefits and risks involved.\nIt's always best to lose weight through a healthy diet and regular physical activity. But if you're among those who have tried and can't lose the excess weight that's causing your health problems, weight-loss (bariatric) surgery may be an option.\nGastric bypass, which changes the anatomy of your digestive system to limit the amount of food you can eat and digest, is the favored bariatric surgery in the United States. Most surgeons prefer this procedure because it's safer and has fewer complications than other available weight-loss surgeries. It can provide long-term, consistent weight loss if accompanied with ongoing behavior changes.\nGastric bypass isn't for everyone with obesity, however. It's a major procedure that poses significant risks and side effects and requires permanent changes in your lifestyle.\nWho is gastric bypass surgery for?\nGenerally, gastric bypass surgery is reserved for people who are unable to achieve or maintain a healthy weight through diet and exercise, are severely overweight, and who have health problems as a result. Gastric bypass may be considered if:\n·Your body mass index (BMI) is 40 or higher (extreme obesity).\n·Your BMI is 35 to 39.9 (obesity), and you have a serious weight-related health problems such as diabetes or high blood pressure.\nGastric bypass surgery doesn't replace the need for following a healthy diet and regular physical activity program. In fact, the success of the surgery depends in part on your commitment to following the guidelines given to you about diet and exercise. As you consider weight-loss surgery, make sure that you make every effort to exercise, change your eating habits and adjust any other lifestyle factors that have contributed to your excess weight\nhttp://www.mayoclinic.com/health/gastric-bypass/HQ01465\nhttp://www.mayoclinic.com/health/gastric-bypass-diet/WT00007\nhttp://www.mayoclinic.com/health/gastric-bypass-surgery/AN01378\nI had gastric bypass surgery in April 2005.  I started out at 268, now I’m 180 and holding, after  1 year and 7 months.  These links will help you in many ways to make a decision if this is for you or not.  I vote yes, because it made such a difference in my life. I was taking 8 pills a day, and after my surgery, I lost my diabetes.  The way they do the surgery, takes your diabetes away.  I no longer have to take glucophage, and I no longer have high Cholesterol or high blood pressure.  I’m down to 2 pills a day.  I went from a size 26-28 to a 16-18.\nMost people struggle with paying for the surgery.  Go to this site, it is a great support system for you, because it’s only people who have had gastric bypass.  Every insurance program has been rated, and you’ll get tips on how to deal with your insurance company, as well as, surgery tips, food tips, and just support. http://www.obesityhelp.com/\nThere is a very good web site by a guy named Basil White.  He’s a govt. worker and a comedian.  He walks you through everything. Very interesting. He had the surgery and did well.\nhttp://www.basilwhite.com/gastric/\nSome other helpful links…\nhttp://dir.yahoo.com/Health/Diseases_and_Conditions/Obesity/Gastric_Bypass_Surgery/\n\nhttp://www.stapleclub.com/general_info.htm\nhttp://www.locateadoc.com/articles.cfm/1454/1337\nhttp://www.dhmc.org/webpage.cfm?site_id=2&org_id=28&morg_id=0&sec_id=0&gsec_id=35507&item_id=35508\nhttp://www.mygastricbypass.com/\nhttp://www.gwdocs.com/health/eHA-eHA_Content_C-Generic_Content_Page_Template_1131123706877.html\nGood luck with your surgery and new life!
1175509
Medicaid in most states will not cover anything that is not considered a medical necessity. Being that weight can be lost via other methods it is generally not considered a necessity. \n\nI am not sure about the state you are in, but in alot of states you would go about applying by being referred to a Dr. that performs the surgery (and that takes Medicaid) by your family Dr. Then the surgeon will fill out all applicable paperwork and get a form back letting them know if it will be covered or not from Medicaid. \n\nIf in your state you don't need a referral just start calling around to different Drs that perform the surgery and finding out if any accept Medicaid. Usually the problem is finding a Dr. to take the insurance in the first place. \n\nGood Luck!!
1164992
Are you moving because your company wants you to work in the US? If so, the company probably has a health plan for its US workers. US health care, unlike almost any other nation, has an employer-provided model of health insurance – most insured Americans have health insurance through work. It’s much less expensive than buying it on your own. As for the pre-existing condition, most plans have a 12-month waiting period, or exclusionary period, for such conditions. In addition, some plans exclude hernias in the first six months of a plan – even if you don’t have a history of having hernias – unless it’s an emergency.\n\nSo, your hernia shouldn’t stop you from getting insurance, but you might have to wait until your insurance covers hernia surgery. After the first waiting period, though, you should be fine.\n\nIf you still have questions, try visiting MostChoice.com. It’s a health insurance Web site that has instant online price quotes and plan details. But it also has a network of licensed insurance agents who can answer any health insurance questions you might have. Just fill out a form, review the online price quotes, and within two days agents should contact you to talk about insurance to cover your hernia and how long you can expect to wait until the insurance will help you pay for the surgery. There’s no cost or obligation. Just wait until one of the agents delivers the insurance policy that’s right for you.\n\nYou can visit MostChoice here: http://www.mostchoice.com/health-insurance.cfm\n\nHope this helps,\n\nBarnes @ MostChoice.
535764
That is up to your surgeon, not  you. Sorry. Give his nurse a call, she'll/he'll have the correct answer for you, not us, anyway,haha.
980409
I am about to have a hernia operation. I have had it for about 7 years (that I know of). It is bothersome from time to time, but if it doesn't bother you much, you can live with it. \n\nThey have no way of knowing how long you have had it. They can't deny it for pre-existing. \n\nI have to pay 20% - my total cost will be around $600.00 - so I would wait until you have insurance.
929902
I would call your state medical board.  What they are doing seems to be quite unscrupulous since they already started the work.  I have never heard of a doctor refusing insurance once he accepted it and started the work.  Good luck.
311029
try to get your state health insurance insurance it's cheaper or low cost as you won't believe. in new york you got childhealth plus and excellus blue cross. i applied at my local hospital.
846129
i'm not sure what ICL surgery is , but if you are military then you have Tricare....you can visit their website and go through a list of benefits (what is and isnt covered). i know for a fact though, if it's not medically necessary , it is usually considered cosmetic...good luck to ya and i've included the link....
210210
A number of companies will exclude pre-existing conditions for the first year and cover them after that.  The best thing to do is shop around.  Try Golden Rule.  They have a pretty good price.  Try getting a plan with a Health Savings Account attached.  Part of your money pays for the insurance and part goes into a cheking account that you can use to pay for any medical expenses.
1023534
Hmmmm...  this could be a little tricky with out insurance....BUT...  there could be ways on working around that..   there are free hospitals (if living in the states) suggestion is to try one of them.....  the wait maybe insanely long but you would not need the insurance.....  just bring a very good and long book to read..  also you can try to contact any hospitals administrator and let them know you need medical attention but can not afford it..   ask if they can help..  some times they have programs to help people without insurance..  really ask about this one..   they even might be able to work out some kind of payment plan or they just might pick up the tab altogether..  in any situation for just about anything sometimes the easiest thing to do is to ask for help...   someone somewhere will always help..  if you can not find help in your area...  look elsewhere..  but keep trying..  take care..
737728
This will give you some excellent links for the lap band.\nCheck out the obesityhelp site,  Your insurance has already been rated.\n\nI had gastric bypass surgery in April 2005.  I started out at 268, now I’m 180 and holding, after  1 year and 7 months.  These links will help you in many ways to make a decision if this is for you or  not.  I vote yes, because it made such a difference in my life. I was taking 8 pills a day, and after my surgery, I lost my diabetes.  The way they do the surgery, takes your diabetes away.  I no longer have to take glucophage, and I no longer  have high Cholesterol or high blood pressure.  I’m down to 2 pills a day.  I went from a  size 26-28 to a 16-18.\nMost people struggle with paying for  the surgery.  Go to this site, it is a great support system for you, because it’s only people who have had gastric bypass.  Every insurance program has been rated, and you’ll get tips on how to deal with your insurance company, as well as, surgery tips, food tips, and just support. http://www.obesityhelp.com/\nhttp://www.mayoclinic.com/health/gastric-bypass/HQ01465\nhttp://www.mayoclinic.com/health/gastric-bypass-diet/WT00007\nhttp://www.mayoclinic.com/health/gastric-bypass-surgery/AN01378\nVitamins I take…  you have to be very faithful about taking them after surgery, because you can become very sick if you don’t.  There were recommended by my surgeon and nutritionist.\nhttp://www.walgreens.com/store/product.jsp?CATID=301120&navAction=jump&navCount=0&id=prod403359\nThere is a very good web site by a guy named Basil White.  He’s a govt. worker and a comedian.  He walks you through everything. Very interesting. He had the surgery and did well.\nhttp://www.basilwhite.com/gastric/\nSome other helpful links…\nhttp://dir.yahoo.com/Health/Diseases_and_Conditions/Obesity/Gastric_Bypass_Surgery/\nhttp://www.stapleclub.com/general_info.htm\nhttp://www.locateadoc.com/articles.cfm/1454/1337\nhttp://www.dhmc.org/webpage.cfm?site_id=2&org_id=28&morg_id=0&sec_id=0&gsec_id=35507&item_id=35508\nhttp://www.mygastricbypass.com/\nhttp://www.gwdocs.com/health/eHA-eHA_Content_C-Generic_Content_Page_Template_1131123706877.html\nGood luck with your surgery and new life!
801875
Did you get the plan from work? Well then ask this your HR manager. If you are buying on your own, I'd rather suggest\na plan with no elimination or waiting periods, like eHealthPlus.
512657
While its true medicaid may not pay for it, but I am sure your doctor can make it seem as though if you do not get this surgery you will die. I mean its the only way they are able to get most insurance companies to pay for it, (more and more are not covering it).\nAlso there are banks/lenders that will loan you the money to pay for surgery, you only need check online or with your own bank.\nwww.capitalonehealthcarefinance.com \nwww.tangcompany.com \nare a couple I have found online. Also you can call your local hospital, or bariatric center to see if they know of a bank. I know often times Bank Of America does loans for some procedures, you may check them out as well. hope this helps you.
602539
Talk to your doctor.  If he is not a surgeon, he should refer you to one.  In order for insurance to cover it, he will probably have to recommend it for medical reasons such as back pain.
1133184
I agree that more information about your current and previous condition will make it easier to explore health insurance possibilities. If you live in the United States and were part of a group health plan, you might be able to take advantage of protections offered by the 1996 Health Insurance Portability and Accountability Act (HIPAA). If you were part of a group health plan in the past two months, then a new health plan may not be able to deny you coverage because of your illness. Further, any time you were under the old group plan will be deducted from a new plan’s waiting period.\n\nHIPAA also limits how far back an insurance company can look-back for a pre-existing condition, in most cases. They shouldn’t deny you coverage because of a hospitalization five years ago. You might want to look into high-risk insurance pools – where people who have been denied coverage band together to get breaks on health insurance.\n\nThe best way to find the answers you need is to talk with local qualified health insurance agents. Chances are, they’ve fielded the questions you have about insurance and have helped people in your exact situation. MostChoice.com is an excellent way to reach state-licensed agents in your area. There’s no cost or obligation to you, and you can also look at health plans and prices from companies like Blue Cross Blue Shield, Humana, and Aetna. \n\nYou can find it here: http://www.mostchoice.com/health-insurance.cfm\n\nGood luck,\n\nBarnes@MostChoice.com
73606
Just having the codes will not be sufficient information to determine whether any procedure will be covered by insurance.\n\nCarriers will cover different procedures.  Each carrier may also offer different types of insurance coverage so not all plans from the same carrier will cover the same procedures.\n\nIt's probably best to work with your dermatologist to determine whether any procedure will be covered. \n\nGood luck.
797087
Stay away from the lap-band at all costs! I had the worst experience of my life with it. *My doctor said it has done permanent damage to my stomach and my surrounding organs!*\nI'm still suffering from abdominal pain and vomiting and I'm still losing weight even though the band has been removed. I keep getting pancreatitis for unknown reasons - and I never had a stomach problem before the surgery and I only had my band in for 7 months. Good news is I'm down to 170 but I wish I wasn't vomiting almost everything I ate and I wish my stomach didn't hurt everyday! \n\nDo the bypass if anything, I wish that I did it. And find a surgeon that knows what they are doing. Ask around your town to find out if other people have had the surgeries and who they have gone to and their experiences with the doctors.  \nAs for if the insurance covers it, I know the BCBS doesn't cover it anymore. The surgeon I had doesn't take Aetna or BCBS as of September 1st anymore. I don't know about Cigna. Most times you have to be 100 pounds overweight and have some problems like diabetes, hypertension and sleep apnea. Call your insurance company and find out.  \n\nDon't worry about what these fools on here say. Do what you need to do. I thought I was doing the right thing. I was 250 pounds and I knew that wasn't going to lose the weight any other way. I work and I pay into my insurance so why can't I use it? I also work at a hospital I know that some of the gastric bypass surgeons do take Cigna so there is a good chance that it is covered as long as you meet the requirements. Medicaid and Medicare also covers both surgeries. \nA good website that explains all the procedures and talks about the insurace is http://www.obesityhelp.com/\n\nGood luck!