Acquiring individual health insurance after banding

[Tricia K.]

For those of you without health insurance, please know that after banding, some insurance companies will deny you individual coverage due to your having lap band surgery (or any other type of WLS). I experienced such denial early this year from 3 different insurance companies, which I've outlined below.

Blue Cross Blue Shield of Louisiana - denied due to lap band placement within the past one (1) year
Humana One - they wouldn't even take my application over the phone because they deny anyone who has had WLS, regardless of the amount of time that has passed
Coventry - denied due to lap band placement within the past three (3) years

However, because BCBS of Louisiana's denial only referenced that I had the lap band placed within the last year and my 1 year bandiversary was September 16th, I re-applied last week and was approved.

[Vegaswildflower]

yea!! Thats great for you!!
thanks for this info, It really is so helpful when you have some one a few months ahead of you, I am self employed and I was turned down by insurace because of my weight.. now it seems thay have another excuse..
well I will have to stay healthy for 6 more months till I will try!!

[Tricia K.]

You're very welcome, Vegas. I've seen this topic come up several times on another board and thought it would be good to share my own experience.

[Kathy]

I was denied due to my weight. Since hubby is self-employed and I quit work when the kiddos started coming, I applied with his individual carrier. They wouldn't cover me, but were happy to cover hubby and my daughter. Ugh!

So I dropped them like a hot potato and we went for group insurance through hubby's small business (BCBS), and we are all on it. It's more expensive, but it was so disheartening and frustrating to be too fat for health insurance.

If hubby weren't incorporated, we'd (I'd) be sunk with no health coverage.

Has anyone done a Health Savings Account? We switched to that this year, and so far it's been good. It's confusing, because we are both the employer and employee. I'd love to compare HSA's with someone who has that type of coverage!

[Diane]

We have indvidual insurance since my husband owns his own business. We had a man come over to our house & help us fill out the paperwork. He told me that since I had my surgery in Mexico that I didn't need to put down on my paper that I had any WLS at all. He said that all problems with my WLS would be directed back to Mexico so the US didn't need to know. Also, there was no official documentation for the US to see so I was clear & free!!

I felt a little bad about not putting my WLS issue on the application. I am a pretty honest person & didn't want to lie. However, the man said - "Trust Me! We're doing the right thing for your health."

I realized later that I would have been completely denied any health insurance if I had documented WLS on the paperwork.

[NurseTeresa]

Kathy I have a health savings account. Have it taken out of my check from work. Did it last year and again this year. It really has saved my butt. Its great to have the money taken out pretax so its like I get all my meds and drs appts for free. The first year I used all but like $13. I figured I lose more the $13 a year in change to the kids or loaning it to friends and never seeing it again.

[Kathy]

Teresa, I'm afraid to spend mine! How odd is that? My goal is to get 5K in there to cover the deductible in case of some off-the-radar emergency, like a broken bone or who knows what? with 2 young children. Hubby's company is contributing $200 a month into the account. It will take a looong time to get the 5K in there. In the meantime, our premiums are much lower and well-care is covered at 100%. So, as long as we stay healthy, we're good.

What's odd is that I KNOW I can be using that debit card for prescriptions, but I don't want to spend it! It's exactly what the ins co wants you to do...be more careful with the money, right? I resent my own hesitancy to spend my own money. Argh.

Is yours set up the same way, with well-care covered at 100% and a huge decuctible?

[NurseTeresa]

No mine is different then yours obviously. I have money put in it each pay period. Then at the end of the year I have to submit all my expenses and be reembursed. If I dont use it then I lose it. Being that I have had several health issues over the last few years it made more sense to me to do this so that I am not left hanging with medical bills like I was three years ago(four surgeries in a matter of 7 months). That didnt include any tests or medications. Can you say expensive!!! Feel free to pm me or talk to me on yahoo if you have it and more questions. Just remember you dont want to lose all that money that you have put into it. The year is almost up.

[Kathy]

Yup, mine is different, the money stays in there forever, and it's pre-tax, only to be used for medical bills. Including things not normally covered under a regular plan. I can use the money for my TT, or Lasix (sp?) surgery, Chiropratic care, dental, whatever, even OTC meds! But I don't, because I want the 5K to collect. hmmmm. Insurance is such a waste of money if you never use it, but it can sure save your butt if you need it. Stinks, don't it?

[ready2bthin]

Kathy,

Would you mind giving me the name of your insurance carrier and of the savings account? I couldn't get insurance either with hubby and kids due to weight, but am in a high risk pool insurance by the state, which may come back to bite me in the future. Anyway, my hubby is incorporated also and when my weight gets into a better range, I will wait awhile and then try again for insurance. You can pm me if you would like.

Thanks!

[Kathy]

Mary, we went to a local agent and she helped us get signed up for it. When it's group health through a company (the company enrolls on behalf of it's employees...even if it's only you all!) you cannot be denied coverage. She found us rates on BCBS of NC, and they offered an HSA plan through Mellon Trust, so that's what we signed up for. We (the company) pay just over $400 a month in premiums, and add $200 a month to the HSA. You have to prove incorporation and fill out surveys each year about the number of full-time employees, yada yada. But an agent will be able to help you get coverage in your area. Being incorporated is the key. Let me know how it goes!