Covered CA

Stacy Booth

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Jan 28, 2014
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I am a graduate student and do not have healthcare. My husband's job is going to pay the fine instead of provide him healthcare. I would like to get health insurance through Covered CA, but I have no clue who would cover my lap-band removal or a revision to DS? Do I call different insurance companies and ask them if they will cover it? I have had my lap-band in for 10 years and I am having a lot of complications. Even if I can't do a revision to DS I really need it removed. Thank you for any insurance advice. I feel really lost with all of this.
 
So glad you asked, it allows me to sneak in a political comment and not break too many rules. ( @southernlady )

The political comment:
Part of the anti Obamacare chorus was "why not just let people go across state lines and buy cheaper insurance?"

The answer is that if all the people who do not need a service go to a state that doesn't require it--State A doesn't cover bariatric surgery, State B doesn't cover fertility services, State C doesn't cover reconstructive surgery after mastectomy--then eventually, the places that sell the cheapest insurance, which covers almost nothing, will have almost all the customers and the states that cover those larger expenses wouldn't have enough people in the pool to keep the insurance company in business. And remember, those things that ARE covered in some states are covered because voters put in office people who would make laws that require that those services are covered.

That said...y'all can pick on the Wingnuts in California and a few other states, but they REQUIRE bariatric surgery be included.

Your job now is to buy a plan that is NOT an HMO and, if possible, one that one of the CA doctors accepts. (Our daughter was on COBRA after being laid off and went with...I think...a Silver PPO...through Blue Shield.) I don't know if Keshishian does, but he removed my band and did my DS over eight years ago, so the boy has a bit of practice at it.

Here's the What Is Covered Where map:

http://www.obesityaction.org/wp-con...y-Treatment-State-Benchmark-Plan-Coverage.pdf



PS...your husband needs a better job. (Unless he's working for a small, struggling, start-up.)
 
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Wouldn't a part-time job at Starbucks be sufficient? I hear their health cover is good and covers WLS.
If she can DO the job...at my heaviest I could not have performed those tasks...and if she can get hired in a still-tough economy...it's a really good idea and many have gone that route.
 
Thank you so much the replies! My husband does need a better job! I cannot have outside employment because I get a research grant for my graduate work. I was looking at Blue Shield. I spoke to Keshishian's office and they said a PPO, but could not be any more specific about insurance.
 
So glad you asked, it allows me to sneak in a political comment and not break too many rules. ( @southernlady )

The political comment:
Part of the anti Obamacare chorus was "why not just let people go across state lines and buy cheaper insurance?"

The answer is that if all the people who do not need a service go to a state that doesn't require it--State A doesn't cover bariatric surgery, State B doesn't cover fertility services, State C doesn't cover reconstructive surgery after mastectomy--then eventually, the places that sell the cheapest insurance, which covers almost nothing, will have almost all the customers and the states that cover those larger expenses wouldn't have enough people in the pool to keep the insurance company in business. And remember, those things that ARE covered in some states are covered because voters put in office people who would make laws that require that those services are covered.

That said...y'all can pick on the Wingnuts in California and a few other states, but they REQUIRE bariatric surgery be included.

Your job now is to buy a plan that is NOT an HMO and, if possible, one that one of the CA doctors accepts. (Our daughter was on COBRA after being laid off and went with...I think...a Silver PPO...through Blue Shield.) I don't know if Keshishian does, but he removed my band and did my DS over eight years ago, so the boy has a bit of practice at it.

Here's the What Is Covered Where map:



PS...your husband needs a better job. (Unless he's working for a small, struggling, start-up.)
Based on your posts you seem to have a wealth of knowledge on insurance. I am in AZ and looking to purchase my own insurance - my employer ins doesn't cover bariatric. There aren't really many bariatric revision surgeons in AZ and I'd like to work with dr K in California. Do you know the best way to go about finding an insurance that will cover him?
 
Thank you so much the replies! My husband does need a better job! I cannot have outside employment because I get a research grant for my graduate work. I was looking at Blue Shield. I spoke to Keshishian's office and they said a PPO, but could not be any more specific about insurance.
Hi Stacy. I had my original DS hear in the Peoria, IL area and my revision to lengthen my Alimentary Limb and my CC a tad too, with Dr K. We have BCBS PPO through my wife's work and it is incredible coverage. $250 for the admit and that was it.

and Dr K is incredible so please go see him, ASAP. He will take car of you well, and you will love him.
 
@Kristaz it might be a good idea for you to start a fresh thread as this one is old, and also because your question is a different one from that of the OP.

Oh, and hi and welcome!

It looks like you are interested in RNY to DS revision. There are very few surgeons who do this complex and high risk operation, and from AZ Dr. K in CA or Dr. Rabkin in San Francisco would be your best bets. Dr. Simper in Utah is also an option.
 
@Kristaz it might be a good idea for you to start a fresh thread as this one is old, and also because your question is a different one from that of the OP.

Oh, and hi and welcome!

It looks like you are interested in RNY to DS revision. There are very few surgeons who do this complex and high risk operation, and from AZ Dr. K in CA or Dr. Rabkin in San Francisco would be your best bets. Dr. Simper in Utah is also an option.
Thanks you!
 

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