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1   CBOEtrader   2018 Feb 16, 11:06am  

Do you think gastric bypass should be covered by medical insurance.

I sell insurance. No plan covers gastric bypass.
2   NuttBoxer   2018 Feb 16, 11:15am  

WHAT!?!? Health insurance DOESN'T guarantee a right to treatment!?!?
3   Ceffer   2018 Feb 16, 11:22am  

Telling a patient he/she is going to die is the most reliable medical prediction. What, how, why, when and where are a little more tricky.
4   WookieMan   2018 Feb 16, 11:30am  

CBOEtrader says
Do you think gastric bypass should be covered by medical insurance.


This is a tough one. What is the rate of people getting the surgery going back to becoming fat assess? If the rate is only like 10% getting back to hippo size, then I think it might be worth it. All the costs associated with being fat medically could easily probably be higher then just the one surgery. Heart attacks, diabetes, etc. Even if 50% go back to being fat, I think it still might be cheaper in the long run. If fatty (now skinny) is using the health care system less, technically that should lower rates. And we have a lot of fatties.

I really know nothing about the field, so I could have a naive view on it. Or a brilliant one. I tend to be brilliant, so there's that.
6   RC2006   2018 Feb 16, 1:05pm  

I am sure his plight weighs heavily on deaths doorstep.
7   CBOEtrader   2018 Feb 16, 1:24pm  

tovarichpeter says
https://www.obesitycoverage.com/insurance-and-costs/am-i-covered/check-my-insurance/item/kaiser-permanente-weight-loss-surgery-criteria

Obesity surgery is fully covered by Kaiser.


Nice find. I stand corrected. Perhaps things are different in CA.

Here's the question I don't have time to research now... Is gastric bypass covered by ACA plans in CA or is this just Kaiser? ACA sets the regulations for minimal essential coverage and for essential health benefits. Gastric bypass is not in either category.

I've had plenty prospects call me and ask for this. The ACA plans in TX specifically mention GP as a non-covered procedure. There is always a gray area when a doctor says a non covered procedure is medically necessary.

Imo, a free market would solve this problem. Look at Lasik surgery as an example wherein there are tons of competitors and financing options to keep the cost low.
8   CBOEtrader   2018 Feb 16, 1:30pm  

WookieMan says
Even if 50% go back to being fat, I think it still might be cheaper in the long run.


Maybe, but the long run is well outside of an insurance carrier's 12 month policy.

As is, we have consumers who can't afford the $1k/month premium of the full price, so we subsidize that price via the ACA. I signed up over 300 clients into ACA policies in last 3 months. Maybe 3 have paid full price.

Our healthcare market is suffering from the heavy hand of regulation.
9   MisdemeanorRebel   2018 Feb 16, 3:34pm  

CBOEtrader says
Imo, a free market would solve this problem. Look at Lasik surgery as an example wherein there are tons of competitors and financing options to keep the cost low.


One way is that Lasik or Gastric Bypass would be covered after X years of coverage.

This person isn't being denied care, if they have insurance and a job, book a flight to Mexico or Brazil and get it there at 1/5th the price, including private room and board and a nursing staff that only has 4 other patients at the same time instead of 12.
10   CBOEtrader   2018 Feb 16, 4:03pm  

TwoScoopsPlissken says
book a flight to Mexico or Brazil and get it there at 1/5th the price, including private room and board and a nursing staff that only has 4 other patients at the same time instead of 12.


This has become a huge business for nosejobs and dental work. Dental work is mostly the cross boarder kind, whereas you can do your nosejob at 5 star resorts in latin america. I know a family that runs a few of these in Panama. Business is booming
11   Tenpoundbass   2018 Feb 16, 4:42pm  

But we've got existing condition clauses, etcetera, etcetera, etcetera

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