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Gastric Bypass and Your Insurance, page 7
A 12-page report about gastric bypass and your health insurance
©2005 Jonni Good
“Contract Exclusion” – What it Means
The first thing you need to know is whether or not gastric bypass surgery is excluded from benefits on your policy.
“Contract exclusion” is a term that describes a specific procedure, diagnosis or medication that a contract will not pay for.
For instance, many policies will not pay for the highly-advertised foot fungus medications that you see so often on TV. Even though those commercials may totally convince you that the medication is needed, your policy may:
• specifically exclude the medication by name,
• or it may exclude the diagnosis for foot fungus in general,
• or it may exclude specific treatments for the condition.
Contract exclusions are usually written in order to contain costs, but they may also be written to exclude payment for treatments that have not been proven to be effective, or which may actually have more risks than benefits.
Some exclusions, such as for the foot fungus medication, are based on data that shows that there are other less costly alternatives that work just as well. There are not enough peer-reviewed scientific studies proving that over-the-counter medications are not just as effective for this condition, and the advertised prescription drugs are expensive. The drugs also have common side effects, such as liver failure, that can cause the need for additional expensive treatment. In order to keep their premiums affordable, many insurance companies have a contract exclusion for these medications, and will not pay for them.
Your benefit booklet or contract will have a list of everything that
your policy will not pay for.
Next Page of Gastic Bypass and Your Insurance Report
- Gastric Bypass & Insurance
- Understanding Your Insurance
- Prepare for Mistakes
- Insurance Regulations
- Health Insurance Customers
- Pre-Paid Health Care
- "Contract Exclusion"
- "Contract Exclusion," cont.
- "Medical Necessity"
- "Pre-authorization"
- "Grievance or Appeal Rights"
- Summary
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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