HELP please! I'm so depressed because of this..... - ThinnerTimes

ttcmona · 07-28-2007, 09:44 PM

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For medical reasons I am wanting to get this surgery done and I was wondering what insurance carriers cover gastric bypass. I am in Califorina and I'm having trouble finding an insurance that covers it. My husband works for walmart dc and has insurance through blue cross and because they buy there own insurance it doesn't cover this surgery.

We were thinking about dropping the walmart blue cross insurance when open inrollment starts again but we're having trouble finding out about who will take me. Does anyone know what I'm talking about or know what I can do? I don't want to wait for years before having the surgery done...I'm scared....

Also, has anyone financed the surgery? How hard is that to do? I really need help. Mona

you can contact me on here or at sweetangelvoice7@yahoo.com

CollegeJoe · 07-28-2007, 11:54 PM

Maam, breathe in, breathe out. Calm down, you already have a post on this. Did u mean to ask different questions?

Trust me, you sound nervous and what not and i think thats the WORST way to go into surgery... do it for the right reasons :-)

ttcmona · 07-29-2007, 12:43 AM

I'm not nervous about doing the surgery. I'm nervous that I won't find an insurance to help me get it done. I've been through so much and I just needed to know if anyone knew anymore than I did. I'm very new to these forums so any help is excepted.

sdgrrl · 07-29-2007, 01:01 AM

With the way each business can design their own coverage, it's really hard to say what company will cover it. There are some folks on here who have BC/BS who had absolutely no problem getting covered. Others, like yourself, have it expressly written into their policy. The only thing I know for sure is that Aetna won't cover it whatsoever. So I guess you'd want to stay away from them. Open Enrollment is usually in October/November, right? Take the time to call various carriers and ask them to what extent do they cover WLS. Make sure you have a PCP who is covered and is also in favor of WLS. Good luck, you are just starting down the yellow brick road and have a lot of ground to cover before being a Loser.

ttcmona · 07-29-2007, 01:13 AM

thanks very much! Any info helps me so much!

SDeRossett · 07-29-2007, 03:38 AM

but it can be very expensive, but in comparison to what the surgery out of pocket would cost it would be a much smaller price to pay. You do not have to drop your husbands insurance. He could simply drop you from it if you get your own policy. Check with your local chamber of commerace and see if you can get insurance through them. CAUTION!!! Once your husband drops you from his insurance he can not put you back on until open enrollment, which varies from company to company depending on when they first started their policy. Generally with BCBS if you do not get back on his insurance during the open enrollment you have to wait until the following year to join unless there is a major change, ie: FOC requires by court order that you put a child on his insurance etc. Good luck! Let us know what's happening.

Sharon

coptergirl · 07-29-2007, 07:05 AM

If insurance fails you, and you own a home, you could refinance and use the equity for your surgery. I would do this as a very last resort, though...but it could be well worth the trouble to save your life. Financing could would but would increase your debt load...

Cinerbelle · 07-29-2007, 08:10 AM

Quote:

Originally Posted by sdgrrl

The only thing I know for sure is that Aetna won't cover it whatsoever.

Has something changed with Aetna??? I had Aetna and they approved me.

ttcmona · 07-29-2007, 10:15 AM

Thanks SDeRossett, coptergirl, & Cinerbelle for the good advice. My husband is talking to someone on monday about blue cross insurance without walmart. I hope & pray it will work out!

Mona

sdgrrl · 07-30-2007, 12:17 AM

That's great, Cindy! And it points out again how capricious coverage can be within a given provider. At one time there were like 3 different people on here who had Aetna and it was specifically written into their policies that not one dime would be spent on weight loss surgery, no matter how dire the need was. I think a couple of them appealed to the state, and I don't remember what happened to the other person.