Pre-Existing insurance for high risk ?

[lisalou79]

Hi all,

I posted this on the other board and wanted to be sure to post here as well. As many of you may know, I am still in the middle of trying to find a way to have DS surgery.

Earlier today, I came across information about pre-existing insurance coverage for folks considered high-risk and have been turned down due to a pre-existing condition.

Well, that's me, and I worked for over two years to get on my husband's insurance only to find they excluded all coverage for morbid obesity.

I researched and found that they will cover WLS but here is my question....I know we do not have a DS surgeon here in Missouri. Would a federal high-risk plan maybe cover this procedure for someone like me who has a high BMI to get DS out-of-state due to lack of available coverage?

I am desperate. It's just that simple. My BMI is well over 60 and I am desperate to find a way to have WLS. I'm still waiting on my Dad to even look at the power point I e-mailed him to see if he will co-sign on a medical loan.

[Janis]

Lisa,

If you wouldn't mind clarifying, are you currently on your husband's policy? If not, how long has it been and why did you lose coverage? Have you applied for an individual policy and been refused coverage?

In my state, a person has to have been without coverage for a number of months and must have applied and been refused coverage under an individual policy. I don't think a person is eligible for the government sponsored health insurance because thier policy doesn't cover a particular procedure but because the person is not able to obtain group or individual health insurance at all.

My employer provided health insurance also excludes WLS surgery so I am curious about the policy to which you refer.

Janis

[lisalou79]

Sure, I have been without insurance for the last three years due to me working part-time and my husband's previous job didn't cover spouse.

In that time I applied for several individual policies for myself, and was either turned down do to my BMI being too high or was quoted an astronomical price.

Recently, as of Jan. 1st, I was finally included onto my husband's new work insurance but it excludes " morbid obesity"

I read the health certificate, they won't pay for a dime for anything related to my obesity. I've been reading information on the O.A.C. (obesity action coalition) and reading the fine print on the high-risk pool insurance (both federal and state)

I unfortunately, am thinking that I won't qualify now that I am on my husband's crappy insurance but was wondering if I still could get on the High-risk pool insurance because they excluded the same condition I've been turned down for numerous times in the past.

I'm reaching here, I know.

I just am still having a hard time finding the rest of the money to self pay for DS and am desperate.

[Janis]

Lisa,

It is my understanding that you would not be able to get coverage through the high risk pool because you do have coverage through your husband. I think having the coverage currently would negate any previous refusals. Please look into it though and don't go on my or anyone else’s posts here, I wouldn't want you to miss an opportunity because I was giving you bad information.

You might look into changing jobs and working for an employer who offers health insurance to part time employees. I've read that Starbucks offers coverage to part time employees and that their insurance covers the DS. It would be great if you didn't have to pay out of pocket.

Good luck and I hope you figure something out. Janis

[smokinstella]

give it a try and see if you can get in for it. After all if they wont cover anything related to your MO then that would mean no sleep apnea treatment if you needed it, or high blood pressure meds, or any number of other things that they could pin on your Morbid Obesity.

[lisalou79]

Thanks guys. I'm going to fill out the app and turn it in. It won't hurt to try.