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kelly
Lv 5
kelly asked in HealthDiet & Fitness · 1 decade ago

Is there an insurance company in Texas that will cover lap band surgery?

Is there a insurance company in texas that will cover the lap band surgery. I currently donot have insurance at all and I would love to get this done but I cannot afford the $15,000 to do so. If anyone has had this done with there insurance what was the weight time in order to get this done and was there any requirments that there insurance company made them do before you got approved to do the surgery? I have been looking at insurance company but I am very confused. Thank you for your help.

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  • 1 decade ago
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    Although I am not 100% positive, from what I understand it is highly likely any insurance company will cover that surgery but there are some requirements that will have to be met first. These requirements are probably nearly the same with any health insurance company that may be available.

    The first qualification is you will have to be diagnosed as morbidly obese. This means a doctor will have to examine you and, given your height, weight, and % of body fat (and possibly more), calculate that you are in danger of shortening your life, significantly. You will have to be more than a few pounds over your ideal weight.

    You will also have to exhausted all other diet options available and have it documented that you did try everything prescribed to you by a physician. You will have to try changing your diet, lifestyle, exercise habits (or at least try exercising first), and possibly other major life altering habits. It will need to be proven that did try everything and were not able to receive and maintain significant results from these attempts.

    Now I'm not sure about this but if after going through the first two requirements you may be given the option for the gastric bypass surgery. The qualifications for an insurance company to pay for that surgery as probably going to be the same as for the lap band surgery. Whether an insurance company will pay for one or the other will probably come down to which surgery is considered less experimental and/or which has less potential negative side-effects or which is considered safer. You may have to go with the gastric bypass instead of the lap band.

    I have a friend who is morbidly obese and has exhausted all the other requirements of her insurance company (those I listed above) and has been given the ok to receive the gastric bypass surgery but chooses not to have it done because of the potential dangers,

    So, I'm sure there might be other requirements in order for an insurance company to cover your desired surgery but this is the best I can do to help you.

    I hope this gives you a better idea on what you are looking for!

    Good luck!:)

  • 5 years ago

    Your health insurance policy is a contract between you and the insurer. They probably gave you a booklet when you signed on that listed what they do and do not cover. You can't make them cover the surgery, unless you can find something in your contract that specifically states that they WILL cover it. Good luck with that. Insurance companies go out of their way to NOT pay for things, even things that should be covered.

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