Which health insurance is best when trying to get covered for gastric bypass?

Question

Which health insurance is best when trying to get covered for gastric bypass?

Answer 1

Group.

Individual health insurance is subject to underwriting in all but 5 states, meaning you don't qualify.  On a group policy you will be subject to a preexisting condition exclusion of either 12 or 18 months. See link below for text of the law.

Good luck,

Don

http://mtnhealthinsurance.com

Answer 2

Depends on what state you live in and what each carrier has stated as far as limitations of coverage. Most carriers want to consider it cosmetic surgery, and if it is a covered benefit there are a lot of hoops to jump through. There are several carriers I have dealt with and they want the individual to:

1. Be on a physician monitored diet for a specific amount of time (sometimes upwards of a year )one that includes healthy diet and exercise

2. Gastric bypass be a last resort to weight loss

3. have a full medical work up with blood work, etc

Then the carrier will do an evaluation and determine whether to approve for benefits. It is a hard procedure to get covered. good luck

Answer 3

A group policy is the best. The fact is if you are a candidate for surgery, that is normally having a BMI greater than 40, you will be out of the height and weight guidelines of all individual policies that would cover the surgery and therefore would be declined.

Answer 4

As the first poster indicated, your insurance (NONE of them) will cover the expense of gastric bypass unless you have attempted all the other means of weight loss which cost far less.

You will need to try a medically supervised diet for at least one year before they will even consider bypass for you, unless you happen to have other conditions which make immediate and rapid weight loss (such as diabetes) a medical necessity.

Beyond that, some insurers simply will NOT pay for gastric bypass, regardless of the situation.

As a side note, I strongly recommend trying the diet and exercise regimen.  The unpleasant side effects of gastric bypass (which do NOT go away) are far more troublesome than is a diet and exercise regimen.

Answer 5

The one through your employer.   Most private policies will NOT cover gastric bypass, as it's a voluntary procedure, like cosmetic surgery.  

Your best bet is getting on a group plan.