Lapband Surgery

Jun 5, 2007

  1. Golddoor
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    Has any one ever tried to write some one who has had lapband surgery? Thats where they tie rubber bands around your stomach to treat weight problems and obesity. I have two leads that have had that and have lost a bunch of weight and now want to try to get individual health insurance. There is nothing in my underwriting guides about it either.
     
  2. somarco
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    somarco That Medicare Expert Guy

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    Most carriers put them on a permanent decline.
     
    somarco, Jun 5, 2007
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  3. SME
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    My experience has been that if you have lost a large amount of wieght recently then they usually add back a certain percentage of weight to you as they assume that you will not keep it all off. Then they use that amount to determine your eligibility on the build chart. On the lap belt my one case of it they considered it to be a cosmetic procedure and exclude it and all complications of it under the standard cosmetic exclusion. But they used the build thing to decline the applicant.
     
    SME, Jun 5, 2007
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  4. somarco
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    somarco That Medicare Expert Guy

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    That's wicked.

    There are some things where a waiver is a non-issue. Complications is not one of them. There are a host of things that can go wrong even years after the surgery.

    When I use a rider there is nothing in the language that addresses complications. I do make exceptions when all offers contain riders. Then we go with the one that is most affordable & least restrictive.
     
    somarco, Jun 5, 2007
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  5. SME
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    It's the same for breast implants.
     
    SME, Jun 5, 2007
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  6. Crabcake Johnny
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    I would need to sit down and meet with the breast implant client to ascertain if they could or could not get coverage. That should not be done over the phone.
     
  7. SME
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    It's not that they will be declined but that it is considered cosmetic and excluded. Sometimes the exclusions are scarier than the riders. Like the ones on colostomy supplies.
     
    SME, Jun 5, 2007
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  8. somarco
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    somarco That Medicare Expert Guy

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    OK, biting my tongue . . .

    Complications from breast implants do happen, but usually not with the same frequency or severity as GB or lapbanding. Some carriers will accept breast implants if they are saline only. Others rate up for implants.

    There are times when riders are acceptable and times when they are not. Since many carriers put GB & lapbanding on the auto-decline list, a rider for complications may be acceptable over no coverage at all.
     
    somarco, Jun 5, 2007
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  9. Golddoor
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    I thought that wasn't that big of deal. I see commercials about lap band and they act like its perfectly safe. I guess I will just submit an Underwriting request and see what each underwriter comes up with!
     
  10. senior-advisor-indiana
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    I would not want to meet my clients with breast implants..........they are atleast 65yrs old....ewwww
     
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