I don't have any medical insurance through my job. Though I lost about 120 pounds during the last year, my coverage application was denied. Am I too fat to get one?
Total Comments: 16
Posted: Sun Jul 04, 2010 01:54 pm Post Subject:
I have extreme depression due to the way I look I lost 40 pounds after giving birth to my beautiful twins
Every time depression starts, just look at those beautiful babys and remember this is what you got for a little hanging skin...it's all subjective and what YOU make it...
due to my pregnancy and C section I have extra skin can I get coverage for that?
I would think it would HAVE to be a medical (NOT cosmetic) need to get any carrier to cover a tummy tuck.
Posted: Sun Jul 04, 2010 04:00 pm Post Subject:
@SD charger: no insurance company is going to underwrite based on what a potential client is trying to accomplish. Let me give you this analog. My client hasn't smoked a cigarette in 3 months is he or she still going to be considered a smoker by the insurance carrier? Most likely yes.
Weight loss can take a lot of commitment but still most insurance companies are going to require a few years of a healthier weight before feeling comfortable about assuming the risk. There's a reason this individual got to that weight in the first place. Maybe, hopefully, she'll never return to it, but if you were betting your money on it, you'd likely want her to prove that she can keep it that way for a while.
I know you see someone who has made an amazing effort to control her weight problem, but also keep in mind that insurance companies underwrite on aggregate and average assumptions; i.e. even though they underwrite individually, underlying assumptions from which they base their decisions are based on how things tend to work from a macro, not micro, point of view.
Posted: Sun Jul 04, 2010 04:03 pm Post Subject:
Lori, is it true that the carriers may deny obese applicants even when they don't have any other existing health conditions? I don't see any particular reason for them to be scared under situations where the applicant is really trying hard and taking positive steps to get reduced?
Absolutely they will deny based on obesity, it is a serious health condition, which leads to even more serious health conditions like hypertension, heart disease, and diabetes.
Posted: Sun Jul 04, 2010 04:06 pm Post Subject:
I have extreme depression due to the way I look I lost 40 pounds after giving birth to my beautiful twins due to my pregnancy and C section I have extra skin can I get coverage for that?
The short over simplified answer to this questions is if you can find a psychiatrist who will diagnose you with clincal depression over the situation, you might be able to get your medical insurer to cover the operation.
Be forewarned that it's not an easy task.
Ususally plastic surgery will not be covered unless there is another medical condition that makes it necessary, and ususally depression doesn't count.
Posted: Mon Jul 05, 2010 01:26 am Post Subject: insurance
BNTRS.....very true in what you're saying. It's just frustrating to see that no one wants to 'take achance' on her. However....I can see the 'point of view' that the Insurance companies have. Tell me something, please?...does she need to continue losing weight, for a certain amount of time, BEFORE she is NOT considered 'high risk'? Hope my question is clear.
Posted: Mon Jul 05, 2010 02:50 am Post Subject:
You're best best is to speak with the underwriting department of general agent for the companies that you are trying to place this with. My guess is they'll want to see weight within an acceptable BMI for a certain length of time.
Where I primarily do business, in Vermont (and in NY before that) there really isn't much of an individual heath insurance market. Both states are guaranteed issue no pre-existing conditions allowed. One might think this would be great, but it means very few insurance companies want to play and those who do have very high rates, so admittedly my applied experience with health insurance meaning major medical on an individually underwritten basis is limited.
Posted: Sun Jul 04, 2010 01:54 pm Post Subject:
I have extreme depression due to the way I look I lost 40 pounds after giving birth to my beautiful twins
Every time depression starts, just look at those beautiful babys and remember this is what you got for a little hanging skin...it's all subjective and what YOU make it...due to my pregnancy and C section I have extra skin can I get coverage for that?
I would think it would HAVE to be a medical (NOT cosmetic) need to get any carrier to cover a tummy tuck.Posted: Sun Jul 04, 2010 04:00 pm Post Subject:
@SD charger: no insurance company is going to underwrite based on what a potential client is trying to accomplish. Let me give you this analog. My client hasn't smoked a cigarette in 3 months is he or she still going to be considered a smoker by the insurance carrier? Most likely yes.
Weight loss can take a lot of commitment but still most insurance companies are going to require a few years of a healthier weight before feeling comfortable about assuming the risk. There's a reason this individual got to that weight in the first place. Maybe, hopefully, she'll never return to it, but if you were betting your money on it, you'd likely want her to prove that she can keep it that way for a while.
I know you see someone who has made an amazing effort to control her weight problem, but also keep in mind that insurance companies underwrite on aggregate and average assumptions; i.e. even though they underwrite individually, underlying assumptions from which they base their decisions are based on how things tend to work from a macro, not micro, point of view.
Posted: Sun Jul 04, 2010 04:03 pm Post Subject:
Lori, is it true that the carriers may deny obese applicants even when they don't have any other existing health conditions? I don't see any particular reason for them to be scared under situations where the applicant is really trying hard and taking positive steps to get reduced?
Absolutely they will deny based on obesity, it is a serious health condition, which leads to even more serious health conditions like hypertension, heart disease, and diabetes.
Posted: Sun Jul 04, 2010 04:06 pm Post Subject:
I have extreme depression due to the way I look I lost 40 pounds after giving birth to my beautiful twins due to my pregnancy and C section I have extra skin can I get coverage for that?
The short over simplified answer to this questions is if you can find a psychiatrist who will diagnose you with clincal depression over the situation, you might be able to get your medical insurer to cover the operation.
Be forewarned that it's not an easy task.
Ususally plastic surgery will not be covered unless there is another medical condition that makes it necessary, and ususally depression doesn't count.
Posted: Mon Jul 05, 2010 01:26 am Post Subject: insurance
BNTRS.....very true in what you're saying. It's just frustrating to see that no one wants to 'take achance' on her. However....I can see the 'point of view' that the Insurance companies have. Tell me something, please?...does she need to continue losing weight, for a certain amount of time, BEFORE she is NOT considered 'high risk'? Hope my question is clear.
Posted: Mon Jul 05, 2010 02:50 am Post Subject:
You're best best is to speak with the underwriting department of general agent for the companies that you are trying to place this with. My guess is they'll want to see weight within an acceptable BMI for a certain length of time.
Where I primarily do business, in Vermont (and in NY before that) there really isn't much of an individual heath insurance market. Both states are guaranteed issue no pre-existing conditions allowed. One might think this would be great, but it means very few insurance companies want to play and those who do have very high rates, so admittedly my applied experience with health insurance meaning major medical on an individually underwritten basis is limited.
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