Last year, I applied to my health plan for bariatric surgery and was turned down. I really want to get this surgery so that I will lose weight. It seems like it should be considered a preventive service, since it would prevent me from having other problems like knee replacements or high blood pressure. Will plans look at my situation differently once Obamacare kicks off in 2014? They talk a lot about preventive care, and being healthy. They should put their money where their mouth is, don’t you think?
Dear Fat Chances,
Health insurance plans will cover medically necessary services. Yours apparently did not meet the plan’s requirements to be considered necessary. Health reform will not change how plans look at these surgeries, though the new rules do require plans to cover certain preventive care services. One of these services is diet and behavioral counseling to promote a healthy diet. Check your plan and see what services are covered. You may be able to see a dietitian who can help you improve your diet.
You can also re-apply for the bariatric surgery. Your health may have changed in the meantime, and you may get a different result from the plan. Your doctor or surgeon can advise you on this.