Insurance questions

[brendabug85]

has anyone ever got a new plan so you could have the gastric sleeve , if so witch one is a good insurance plan to use , thanks

[RehabNurse]

It depends.....

For instance, Humana could have 10 different health plans for 10 different companies. It's the same story for Blue Cross/Blue Shield, Anthem, Cigna, Aetna, United Healthcare, and so forth.

As an example, my friend and I were both sleeved while insured by a Blue Cross/Blue Shield of Texas PPO plan. I was insured by company-sponsored health coverage through my job while she was insured through her husband's employer.

I had a 90/10 PPO co-insurance plan, meaning the insurance paid 90 percent and I paid 10 percent of all medical bills. What was my total out-of-pocket cost for the sleeve? $4371.

On the other hand, my friend paid less than $500 for her sleeve. It was the same insurer, but because different employers administered the health plan, the quality of benefits and out-of-pocket requirements differed.

Also, many employers implement bariatric surgery exclusions on the insurance coverage they offer because they simply do not want to pay for it. Most of the health plans on the state insurance exchanges also exclude bariatric surgery.

[Christie13]

You'll just have to do your research and specifically inquire about bariatric surgery.

[jamma]

My surgeon REQUIRED patients to first check with their insurance company specifically about the Gastric Sleeve so there were no surprises at the end.

[donnahellno]

Do you literally just call the member services number on the back of your insurance card?

I've done some digging around inside my health insurance online portal, as well as a few web searches, and from everything I can find, my insurance company does pay for surgery, and I believe at 100% (we have INCREDIBLE insurance, which I am thankful for every day), as long as I meet their (admittedly few) qualifications. But I always like to make extra sure. I tend to check and double check everything.