There is a strange quirk with health insurance that is causing some people to endanger their health in order to qualify for the health care that they need. People who are just under the weight limit cannot qualify to have their health insurance pay for weight loss surgery. Some resort to intentionally gaining more weight, in order to have their health insurance pay for their surgery.
Health insurance is supposed to help people to afford to pay for the health care they require. A person pays premiums, (and some will also pay a deductible). The health insurance company, in return, covers at least some of the cost of the treatment, surgery, and prescription medication that the person needs.
In reality, many health insurance companies will limit the amount of care that they will pay for. This is often done by placing a limit on what it takes to qualify for a certain type of treatment, surgery, or other form of health care.
This is the case with weight loss surgery. Strict insurance company policies limit the number of people who can qualify to have their health insurance cover the cost of their weight loss surgery.
Right now, a person must have a BMI of 35 or 40 before insurers have to cover that form of surgery. The FDA recently approved the use of Lap-Band surgery for patients who have a BMI of only 30. The person also must have at least one weight-related disease, (like high blood pressure, or diabetes, for example), in order for their health insurance company to cover the cost of the Lap-Band surgery. The other way to qualify for coverage of Lap-Band surgery is to have a BMI of 40, (for people who are otherwise healthy).
This puts some people in a rather absurd situation. Some people are just under the weight limit, or just below the BMI, that they must hit in order to qualify to have their health insurance policy cover the cost of weight loss surgery.
This is leading a lot of people to intentionally try and gain more weight, so that they will qualify for coverage. These types of surgery can cost $20,000 for people who have to pay for it out of pocket.
Essentially, what we have is a group of people who are at risk of developing certain types of diseases and conditions because the person is overweight. Many are putting effort into gaining even more weight, so that they will qualify to have the cost of their weight loss surgery covered. In the meantime, they are endangering their health even more, in order to get a surgery that can improve their health.
Before you decide that gaining more weight is the easy answer you are looking for, there is something important to keep in mind. Some insurance companies may decide that people who intentionally gain weight in order to qualify for coverage for a weight loss surgery are committing insurance fraud. If that happens, then you may find yourself paying for the entire cost of the surgery, out of pocket, anyway.
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