5 ms·

When I was fat, my insurance wouldn't cover any weight loss procedure (including just visiting my primary physician to discuss my options for weight loss-- a lo

When I was fat, my insurance wouldn't cover any weight loss procedure (including just visiting my primary physician to discuss my options for weight loss-- a lovely $250 surprise) because I had no obesity-related health problems (heart disease, diabetes, joint issues, etc). So a hospital can actually do a lot for fatties. Being able to talk to a nutritionist, set up a plan, gain access to any applicable medication, addressing out underlying inflammation/hormone/disordered eating...

hn92726819 4y ago
How many pounds over a healthy weight were you? 20? 50? 150? Just curious
- PuppyTailWags 4y ago
  Doesn't matter. I asked how significantly overweight I had to be to have access and the insurance company told me there's no weight-- it's purely obesity related health condition only. Theoretically also I could be 10 lbs overweight and diabetic and get a fast track to ozempic, lol. At one point my family medicine guy suggested he could write down something arguable just to get me to a nutritionist (think making me do some wicked pose while measuring my blood pressure and then writing it down as "high blood pressure") and I told him just don't bother. We did however in future meetings ensure I always had something else to talk about besides my weight progress so I'd never get billed again.
- dangwhy 4y ago
  They usually consider you for surgery if your bmi is over 40 and you've tried ( and failed) conservative approaches to weightloss.
  - deleted 4y ago
    [deleted]
  - PuppyTailWags 4y ago
    No, that's not the case for many insurance companies. My insurance company only qualified surgery if you had a qualifying health condition. If you were just obese you didn't qualify.
- nradov 4y ago
  The most serious health effects tend to come not from absolute weight per se, but from excessive body fat percentage. And particularly from visceral (intra-abdominal) fat, which is far more dangerous than subcutaneous fat in terms of risk for conditions like type-2 diabetes, arteriosclerosis, and COVID-19. The excess adipose tissue causes subtle, progressive damage which won't necessarily be obvious in the regular preventative screening exams that most younger patients receive. But as some point after age 50 or so the systems decompensate and the patient's overall health deteriorates rapidly.
kspacewalk2 4y ago
> When I was fat, my insurance wouldn't cover any weight loss procedure (including just visiting my primary physician to discuss my options for weight loss-- a lovely $250 surprise) because I had no obesity-related health problems (heart disease, diabetes, joint issues, etc). This is such a stupid, self-defeating policy for an insurer. Until your problem costs us a lot, don't you dare try to mitigate it on our dime!
- ecommerceguy 4y ago
  >> self-defeating policy for an insurer. Bariatric procedures can be included as a sort of "rider". This is typically written into self funded plans. Bariatric is not an essential coverage therefore ACA qualified plans do not typically include them - unless medically necessary.
- aqme28 4y ago
  In the US with healthcare tied to either employment or medicare, by the time these costs come around you're likely to either transfer out of this insurance or to the medicare option. Either way, it's someone else's problem (from the perspective of the current insurer).
- SV_BubbleTime 4y ago
  I don’t know, looking at the percentages… I’m not sure preventative care for obese people is sustainable at this point. Not that I shed tears for insurance companies, but I think this would be a lot of money. Now… the problem should have been addressed twenty years ago before it went critical.
- njarboe 4y ago
  After Obama Care, insurance companies profits are now capped at 8% (think that is the number) of revenue (ie premiums) in the US. So one way to grow revenue is to have higher costs per policy, pay out more, and charge higher premiums. If you are at 8% profit and you reduce your payouts as you are describing with preventative care, then you don't get to keep that money. You have to pay it back to the insurance buyers. Very perverse incentive.
pyuser583 4y ago
I received a lot of these services for free at the local health food store. Offering nutrition advice at food stores is probably a better approach then doctors visits.
tinus_hn 4y ago
The number one problem is that a visit with a discussion costs $250 which is absolutely ridiculous, obscenely expensive. Healthcare insists on the very best, most expensive in gauzes and then when they can’t afford them they let people die, instead of using cheaper gauzes which are just fine and have been used for years.

hn92726819 4y ago

How many pounds over a healthy weight were you? 20? 50? 150? Just curious

PuppyTailWags 4y ago
Doesn't matter. I asked how significantly overweight I had to be to have access and the insurance company told me there's no weight-- it's purely obesity related health condition only. Theoretically also I could be 10 lbs overweight and diabetic and get a fast track to ozempic, lol. At one point my family medicine guy suggested he could write down something arguable just to get me to a nutritionist (think making me do some wicked pose while measuring my blood pressure and then writing it down as "high blood pressure") and I told him just don't bother. We did however in future meetings ensure I always had something else to talk about besides my weight progress so I'd never get billed again.
dangwhy 4y ago
They usually consider you for surgery if your bmi is over 40 and you've tried ( and failed) conservative approaches to weightloss.
- deleted 4y ago
  [deleted]
- PuppyTailWags 4y ago
  No, that's not the case for many insurance companies. My insurance company only qualified surgery if you had a qualifying health condition. If you were just obese you didn't qualify.
nradov 4y ago
The most serious health effects tend to come not from absolute weight per se, but from excessive body fat percentage. And particularly from visceral (intra-abdominal) fat, which is far more dangerous than subcutaneous fat in terms of risk for conditions like type-2 diabetes, arteriosclerosis, and COVID-19. The excess adipose tissue causes subtle, progressive damage which won't necessarily be obvious in the regular preventative screening exams that most younger patients receive. But as some point after age 50 or so the systems decompensate and the patient's overall health deteriorates rapidly.

kspacewalk2 4y ago

> When I was fat, my insurance wouldn't cover any weight loss procedure (including just visiting my primary physician to discuss my options for weight loss-- a lovely $250 surprise) because I had no obesity-related health problems (heart disease, diabetes, joint issues, etc). This is such a stupid, self-defeating policy for an insurer. Until your problem costs us a lot, don't you dare try to mitigate it on our dime!

ecommerceguy 4y ago
>> self-defeating policy for an insurer. Bariatric procedures can be included as a sort of "rider". This is typically written into self funded plans. Bariatric is not an essential coverage therefore ACA qualified plans do not typically include them - unless medically necessary.
aqme28 4y ago
In the US with healthcare tied to either employment or medicare, by the time these costs come around you're likely to either transfer out of this insurance or to the medicare option. Either way, it's someone else's problem (from the perspective of the current insurer).
SV_BubbleTime 4y ago
I don’t know, looking at the percentages… I’m not sure preventative care for obese people is sustainable at this point. Not that I shed tears for insurance companies, but I think this would be a lot of money. Now… the problem should have been addressed twenty years ago before it went critical.
njarboe 4y ago
After Obama Care, insurance companies profits are now capped at 8% (think that is the number) of revenue (ie premiums) in the US. So one way to grow revenue is to have higher costs per policy, pay out more, and charge higher premiums. If you are at 8% profit and you reduce your payouts as you are describing with preventative care, then you don't get to keep that money. You have to pay it back to the insurance buyers. Very perverse incentive.

pyuser583 4y ago

I received a lot of these services for free at the local health food store. Offering nutrition advice at food stores is probably a better approach then doctors visits.

tinus_hn 4y ago

The number one problem is that a visit with a discussion costs $250 which is absolutely ridiculous, obscenely expensive. Healthcare insists on the very best, most expensive in gauzes and then when they can’t afford them they let people die, instead of using cheaper gauzes which are just fine and have been used for years.