insurance companies in NJ that cover bariatric surgery?
Looking for health insurance companies in new jersey that cover bariatric surgeries. Any advice is appriciated.
Sorry, I am unwilling to travel to foregin countries to have this surgery. If they hurt me in some way, it would be much harder to gain compensation, plus I have a 1 year old that I can’t leave, nor take to another country.
I have two answers: one for where you might find insurance and one about bariatric surgery. The short answer for where you can find health insurance is: it depends. You can find coverage through most health insurance companies, but most private insurers include riders on their standard policies that deny coverage for bariatric surgery. According to a New Jersey Work Group report on bariatric surgery, HMOs in the state must include coverage for bariatric surgery. I’ve included a link to the report, which also alludes to Medicare/Medicaid changing its stance on coverage for this procedure. It wasn’t until this year that Medicare/Medicaid considered obesity an illness and expanded coverage for obesity treatment. The next link in the sources section is to a New Jersey HMO report card rating HMOs in the state.
The above answerer quotes an interesting article from a medical group that specializes in obesity treatment. You’re kind of lucky that you are looking for treatment in New Jersey because the state conducted an in-depth study into how well bariatric surgeries are being executed. This was in response to the fact that the number of procedures increased by almost 10 times in just five years. I’ve linked to the press release describing the results of the Work Group study. Although they did not recommend any strict rules for where to go for treatment, they did say that a successful bariatric program “would perform at least 125 surgeries a year, with each surgeon having a lifetime experience of at leat 125 procedures.” The report also goes on to say that a good program would include a physician medical director for bariatric surgery.
You might want to use the above criteria to find doctors that you’d want to perform the procedure. I’ve included a link to a list of New Jersey doctors who specialize in bariatric surgery. Then you can see what health insurance the work with and go from there. I would also speak to health insurance agents in your area. Chances are, they’ve fielded your question before and can quickly help you out. Try MostChoice.com. You can review different plans and speak to multiple agents without any cost or obligation.
You can find MostChoice here: http://www.mostchoice.com/health-insurance.cfm
Hope this helps
Barnes@MostChoice
July 16th, 2010 at 6:02 pm
Bariatric surgery,Weight loss surgery-like gastric bypass /lap band surgery / stomach stapling and gastrectomy have become very common and very safe now. My cousin got her Roux-en-Y gastric bypass surgery in India. She has lost more than 65 lbs in 5 months and is very happy with the results. The price for obesity surgery is very less in India. My cousin just paid 25% of the cost she was quoted in America. She got her surgery from a company called Forerunners Healthcare.
Forerunners Healthcare is very famous in India. I read a lot about them in the Newspapers and magazines. I have read a lot of their patient stories also. They arrange financing for USA, Canadian, UK and other international patients who plan to have surgery abroad for low cost, as bariatric surgery and weight loss surgery is not covered by insurance. They also have photos pasted of their International patients. You can checkout their website. There are huge cost savings. As a doctor I personally believe that your Obesity surgery can be easily handled in India, as the quality of healthcare available In India is simply best in the world. The surgeons are USA/UK trained and facilities are 5 star.
http://www.forerunnershealthcare.com
Hope this helps.
References :
July 16th, 2010 at 6:28 pm
The increasing costs associated with weight loss surgery have lead many insurance carriers to "change the rules" in terms of providing this coverage. Up until recently, nearly all private insurance carriers accepted the guidelines laid down by the 1991 National Institutes of Health Consensus Development Panel as qualifications for weight loss surgery. However, the recent explosion in the number of surgical procedures has resulted in many carriers adding qualifiers to the NIH guidelines such as 6 or 12 months of a continuously medically supervised diet. Though most patients seeking weight loss surgery have accumulated years of failed diet treatments, these attempts are rarely associated with written documentation of those efforts. An extended diet program lacking written documentation over a 6 to 12 month period is not considered sufficient qualification by many private insurance carriers.
These new qualifications have tremendously extended the waiting period for patients seeking weight loss surgery. Many become discouraged by repeated denials from their insurance carrier and stop seeking weight loss surgery altogether. Other carriers such as Blue Cross Blue Shield of Florida have taken a more direct approach by simply denying coverage altogether. Although Blue Cross spokespersons have provided a number of reasons for the decision to stop covering weight loss surgery, it seems clear to most observers that the underlying reason is high cost. The increased cost associated with weight loss surgery will likely drive other carriers to add exclusionary clauses for coverage of these operations into their new policies.
The best advice would come from a qualified health insurance agent. You may want to go to: http://www.insureme.com/landing.aspx?Refby=614504&Type=health. It is a free service which can provide you the information you need. You can even talk to local agents if you have any questions. You may want to put in the comments section of the quote that you are looking for a policy that covers the surgery without the waiting period.
References :
http://www.njbariatricspc.com/tips/insurance.asp
July 16th, 2010 at 6:56 pm
I have two answers: one for where you might find insurance and one about bariatric surgery. The short answer for where you can find health insurance is: it depends. You can find coverage through most health insurance companies, but most private insurers include riders on their standard policies that deny coverage for bariatric surgery. According to a New Jersey Work Group report on bariatric surgery, HMOs in the state must include coverage for bariatric surgery. I’ve included a link to the report, which also alludes to Medicare/Medicaid changing its stance on coverage for this procedure. It wasn’t until this year that Medicare/Medicaid considered obesity an illness and expanded coverage for obesity treatment. The next link in the sources section is to a New Jersey HMO report card rating HMOs in the state.
The above answerer quotes an interesting article from a medical group that specializes in obesity treatment. You’re kind of lucky that you are looking for treatment in New Jersey because the state conducted an in-depth study into how well bariatric surgeries are being executed. This was in response to the fact that the number of procedures increased by almost 10 times in just five years. I’ve linked to the press release describing the results of the Work Group study. Although they did not recommend any strict rules for where to go for treatment, they did say that a successful bariatric program “would perform at least 125 surgeries a year, with each surgeon having a lifetime experience of at leat 125 procedures.” The report also goes on to say that a good program would include a physician medical director for bariatric surgery.
You might want to use the above criteria to find doctors that you’d want to perform the procedure. I’ve included a link to a list of New Jersey doctors who specialize in bariatric surgery. Then you can see what health insurance the work with and go from there. I would also speak to health insurance agents in your area. Chances are, they’ve fielded your question before and can quickly help you out. Try MostChoice.com. You can review different plans and speak to multiple agents without any cost or obligation.
You can find MostChoice here: http://www.mostchoice.com/health-insurance.cfm
Hope this helps
Barnes@MostChoice
References :
New Jersey Work Group Report on Bariatric Surgery
http://www.nj.gov/health/hcsa/documents/bariatricsurgeryrpt.pdf
Press Release on Work Group Report
http://www.state.nj.us/cgi-bin/dhss/njnewsline/view_article.pl?id=2788
New Jersey HMO Report Card
http://www.state.nj.us/health/hmo2005/
Doctor List
http://obesityhelp.com/morbidobesity/bariatric+surgeons+in+new+jersey.html
Talk With Local Insurance Agents (fill out the form)
http://www.mostchoice.com/health-insurance.cfm