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Gastric Bypass and Your Insurance, page 5
A 12-page report about gastric bypass and your health insurance
©2005 Jonni Good
The Real Customers of Health Insurance Companies
The main customers of health insurance in the United States are small business owners. Large companies often self-insure their employees, in order to keep better control of costs. This also allows many large companies to avoid state-mandated coverage requirements. Large unions are also often self-insured. This means that most commercial insurance policies are designed to appeal to the owner of smaller companies, and these owners are the insurance companies’ main customers.
In the past, some insurance companies, such as Aetna and some Blue Cross plans, included coverage for weight loss surgery in their standard plans. The rising cost in premiums has caused these companies to reconsider, because their customers, (the employers), could not afford the increasing costs. Removing weight loss surgery from their standard plans is just one of the ways that the insurance companies help slow the increasing cost of premiums.
Even though weight loss surgery is rarely found in standard policies, most insurance companies offer a “rider” that adds coverage to a policy if an employer chooses to pay for it. These riders make the premiums cost more, and these extra costs will sometimes be passed on to the employee.
Profitability
Insurance companies also need to make a profit. In order to continue in operation, their premium rates must bring in more revenue than is spent on claims, operating costs, and advertising.
A claim for gastric bypass surgery will be from $25,000.00 to $35,000.00, without complications. If something goes wrong, the costs can easily soar over $100,000.00, and complications are common. For this reason, insurance companies will either exclude gastric bypass surgery from benefits, or they will very carefully consider every pre-authorization request for this treatment. And if the policy covers gastric bypass surgery, and if your pre-authorization request is approved, you may still be required to receive your surgery through a clinic that has been approved by your insurance company.
This requirement is becoming more and more common, because studies have shown that most of the complications and deaths associated with gastric bypass surgery are happening when the surgery is performed by inexperienced or poorly trained surgeons.
Some clinics, however, have success rates that are far higher than average, and the possibility of dangerous complications is much lower when your surgery is performed there. For this reason, it is highly recommended that you utilize one of these clinics for your surgery, even if your insurance company doesn’t cover the procedure.
Next Page of Gastic Bypass and Your Insurance Report
New research shows that low-calorie diets can cause food obsessions and binge eating. They can even make sugar addiction worse. No wonder most people end up fatter than they started when they try to lose weight with a low-calorie diet.
The answer? The New Craving Control Diet.
Lose 3 to 5 pounds a week without surgery, starvation diets or dangerous appetite suppressant pills. Enjoy the satisfying, delicious diet that controls your appetite naturally, reduces food cravings, and helps burn fat faster.
Finally - Fitness Without Pain:
Have
you ever purchased exercise videos you couldn't use because the exercises
were too strenuous or caused you too much pain? If so, I found the perfect
fitness program for you.
It's called the "Runner's Yoga" program, but it's definitely not just for runners.
These specially-selected yoga exercises are easy to learn, and take only 30 minutes for a full workout. They firm up your muscles, give you greater flexibility, and help calm the mind so you can concentrate better during the day.
And all without any pain at all. In fact, it can even help reduce pain if you now suffer from injured knees or joints.
To learn more about this new fitness yoga program, click here.
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