Gastric Bypass Surgery Support Group

Gastric bypass (GBP) is any of a group of similar operative procedures used to treat morbid obesity, a condition which arises from severe accumulation of excess weight in the form of fatty tissue, and the health problems ("co-morbidities") which result. If you are considering gastric bypass or have had it, join the community where we share our experiences and find support.

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Gastrointestinal System
/ Gastric Bypass Surgery Support Group

Disappointed

Bethers
Bethers
Hi I am new to this group, and was all excited to join because I finally decided to get the surgery. I have my appointment with the nurse on Thursday.

I got a call today from the clinic and was told that my insurance plan does not cover bariatric surgery. But if I still want the procedure I can have it for about say $20,000. Just makes me mad I have crappy insurance as it is. $200 premium $750 deductible to get them to pay 75% and a maximum deductible of $3750.

Not mad at the insurance but more my boss for only offering his employees a crappy plan that I pay through the nose for but get basically nothing in return.

I bet my plan covers Viagra!!!
But not something that could potentially save my life, prevent the Diabetes that I am close to having, save me from heart disease and possibly other life threatening problems I could have. Not to mention that I suffer from pcos that make it virtually impossible, at least very difficult, for me to lose weight.

Now I have to decide if I should keep my nurse's appt or not.

Very bummed!
deleted_user
deleted_user
I am so sorry. I do know how you feel. I had to wait over 10 years to have insurance that would cover my bypass. By that time, it was medicare because I am on disability due to my many illness some caused by obesity. If I had it to do over again, I would have changed jobs to have insurance that would pay for it. Just a consideration.
deleted_user
deleted_user
Oh no, that is really disheartening. It is definitely becoming more common to cover the surgery but with a pretty hefty out-of-pocket cost. It will be good when it starts paying as well as the other surgical procedures, in my opinion.

In the meantime, I'm with nurse2067. Do you work for a smaller employer? Sometimes the smaller companies can't afford the higher premiums for better insurance plans/coverage. You'll have a better chance at it being covered with a larger employer. And if you're in the market to change jobs, you can make that part of your job search criteria. Most reputable employers will be glad to share with you the details of their benefits BEFORE you accept a job.

Good luck to you!

Tonya
RNY 11/19/2013
ShelleyNY
ShelleyNY
With open enrollment going on right now are you able to shop around for insurance? Are you able to appeal to your insurance? Can your doctor submit a letter of medical necessity to the insurance?

I wish you all the best!
Shelley
susanq35
susanq35
Don't give up! Hoping there is a way for you. I had to wait for better insurance too. I know how frustrated you must be.
becca1960
becca1960
SO sorry!! I hope it works out for you somehow!
Bethers
Bethers
Hello ladies..yes the company I work for is a small company. I have been looking for another job, pretty much when I started this one 1 1/2 ago. I just kick myself though because I worked for the State for 13 years and although the insurance wasn't as good as it was when I first started the surgery was covered, I am trying to get back in but its difficult. I am going call MNSure (obamacare) tomorrow and see how that works. I can only imagine if this isn't covered what else isn't. It just frustrates me because I finally made the decision and now I hit a roadblock. thanks all for your support and advice.
Boo1962
Boo1962
Hang in there, keep asking, and researching! You never know what you will find.

I'm rooting for ya!

Boo
sarasota34233
sarasota34233
What I can tell you about Obamacare is that I had to switch to an Obamacare program, per se, starting on January 1st, because I have a pre-existing condition for migraines for which I have a rider on my current health care plan (I have private health insurance...and they had it as a pre-existing condition and paid nothing for care of my migraines and starting in January that is illegal). While we don't meet the income requirements for the affordable care plan we still qualify for the insurance but at the higher rate. All of the plans that I looked at...and I looked at a ton...had bariatric surgery as an exclusion. Seriously. Every single one This was for the state of Florida. I was curious about some of the things it covered and didn't cover and this was one thing that was not covered. These are GREAT health plans but plans that exclude bariatric treatment. Go figure.
SgtSmith
SgtSmith
sorry to hear that. Our ins switches back and forth. The 1st time I was trying to get surgery I couldn't get my ducks in a line in time and the new year came up and they cut bariatric out. Then another year passed and they put it back in.
So don't give up! I doono what your prospects of finding another ins plan are, I had to go with a group plan becasue I was uninsurable on my own.