Insurances not covering the Sleeve???

I was told that many insurances were not going to approve the sleeve starting this year. Luckily, I had the process going since last year and squeezed in. Has anyone heard of this or why this wouldn't be covered, in my eyes this is a better way to go! Hmmm....

Hi Missapril,

I know that there are several Australian health Funds at the moment that have recently chanegd their policies to not include this surgery. However anyone who had the surgery booked by march 31st was still covered.

** It is always recommended to seek individual financial advice from your health fund

Australin health insurance has not changed their policies to NOT include the sleeve. The sleeve along with all weight loss surgery is covered by ALL australian health insurance companies. Some insurance companies in Australia have moved their weight loss surgery to a different level of coverage is all. this of course mean HIGHER level and thus more money. They do this for having babies or heart surgery etcetc the list is quiet extensive. And I think you can pretty much blame the lapband for that with the amount of follow up surgery required with it as all weight loss surgerys get lumped together.

All the hype about leaks and months in hospital if you have one with a sleeve. Fact at any give time in Australia there are more ICU beds occupied by band patients with a leak in their stomach from the lapascop or erosion than sleeve patients.

applesauce

applesauce wrote:

Australin health insurance has not changed their policies to NOT include the sleeve. The sleeve along with all weight loss surgery is covered by ALL australian health insurance companies. Some insurance companies in Australia have moved their weight loss surgery to a different level of coverage is all. this of course mean HIGHER level and thus more money. They do this for having babies or heart surgery etcetc the list is quiet extensive. And I think you can pretty much blame the lapband for that with the amount of follow up surgery required with it as all weight loss surgerys get lumped together.

All the hype about leaks and months in hospital if you have one with a sleeve. Fact at any give time in Australia there are more ICU beds occupied by band patients with a leak in their stomach from the lapascop or erosion than sleeve patients.

applesauce

Yeah I am with NIB I was covered under the coverage I had, but the level of cover I have has changed as of the 1st of june I think that it no longer covers weight loss surgery. I am on fairly high cover, so I'd hate to think how much I'd have to pay a month to cover the op now!

I am with Medibank Private, and have a low level of cover. When I got my letter stating that there were policy changes, I rang Medibank and enquired. Cardiac and psych. are no longer covered for me, but sleeving still is.
Cheers.

Hi,

My Australian health insurance company (Australian Health Management) just sent around a circular saying it will cease covering lap-band procedures on the cheapest hospital plan from July. 2010. Their stated rationale was that the operation had become too popular and was costing the fund too much money. It is still covered on more expensive plans, and they are honouring existing admission bookings.

They didn't explicitly mention the sleeve in the circular, but I was happy I got my sleeve op in under the wire.

I gather some American HMOs have a different rationale: that they regard sleeve surgery as "experimental," and so won't cover it. You'll have to check out what's going on in the States separately.

I spoke to NIB today, I am with them and had Singles Plus, an old policy. They said as of June/July (?) my cover wouldn't include obesity surgery, so I upgraded to top cover. Cost now for top everything (hospital and extras) except pregnancy/fertility services: $60.59 per fortnight with $500 excess or $70.16 with $250 excess.

So mine goes up about $8/month, but I now get 75% back on extras which should save me a lot on dietician, psychology and physio.

http://www.smh.com.au/lifestyle/wellbeing/health-fund-cuts-will-affect-gastric-banding-patients-20100514-v4hg.html