Just Got Referred To Orientation From My Kaiser PCP

bookfaerie
on 9/5/10 12:34 pm
 I have a few questions. Does anyone know if all the traditional SoCal Kaiser HMO's cover the surgery? I looked online at my benefits sheet and it doesn't say anything. My husband is an IBEW electrician if that helps. I called member services and asked for an EOB but I would be interested if anyone else has an answer. Also, what is the copay for the surgery? Anyway, I'm just getting started. I haven't even gotten my packet in the mail yet, so I'm sure I will have a million questions. This is just number one.
Katrina F.
on 9/6/10 12:20 am - So.Cal, CA
Hello I am a SoCal Kaiser Post WLS patient.

Each plan is different for my plan, they covered the surgery but I had a co pay of 250$ Cause of the 1 night stay at the hospital. I had the VSG done back in April, and I love it.

I loved my kaiser options classes so MUCH!!! I would still be in them if I could. I may be seeing about a support group tonight at my former options class location. I am to the point I need a kick in the ass.

If you have questions please let me know.

Also what area of So.Cal are you in?

God bless our troops

danas
on 9/6/10 2:11 am - CA

If they referred you to bariatrics, I'm pretty sure that means WLS is covered for you. Your co-pay would be whatever your co-pay normally would be for hospital stays. I don't have a hospital stay co-pay so I didn't pay anything & I was there for 7 days. I don't know much about the Option classes because I filed a grievance to not be required to take them, so I didn't have to take them.

Won against big bad (SoCal) Kaiser for a Duodenal Switch  Haven't heard of DS? Kaiser wants it that way. Come on over & read the truth
Hit goal (Normal BMI) on 2-10-11!    I LOVE my DS!!
My approval process timeline:
02/12/09 - Dr. refused to refer me for WLS
03/03/09 - Vented/whined about it on another board, planned to just wait until next year & switch plans
Let's see what happens!  **updates in blog**
acbbrown
on 9/9/10 4:18 pm - Granada Hills, CA
Can I ask what your put in your grievance that allowed you to skip the classes?
bookfaerie
on 9/6/10 9:51 am
 I'm in Redlands, (Inland Empire) my options classes would be in Fontana. :)
ahill4455
on 9/6/10 3:28 pm
I would say call them up and ask.  The benefits line will tell you your payments for this surgery.  I will call tomorrow just to verify that I have no co-payment.
  HW :364 
  SW: 328.5
  CW: 219.8
  GW: 185

Pre Op:  35.5 lbs lost
Month 1: 30 lbs lost
Month 2: 12 lbs lost
Month 3: 12.7 lbs lost
Month 4: 13.4lbs lost
Month 5: 6.2 lbs lost
Month 6: 8.2 lbs lost
Month 7: 7 lbs lost
Month 8: 7 lbs lost
Month 9: 3.4 lbs lost
Month 10: 4.2 lbs lost
Month 11: 0 lost
Month 12: 4.6 lbs lost
      
terryrow61
on 9/7/10 4:02 am - Garden Grove, CA
Hi. My suggestion is that you call the "benefits" number on your Kaiser Card and ask them straight out what your copay is for the type of surgery you are interested in because there are various plans.  For example, my my Kaiser HMO plan paid for everything with the exception of the $100 copay for the hospital in San Diego.
I live in Orange County and have Kaiser HMO.  I attended the Options Program at the Kaiser in Orange January  through June 2007.  I had my surgery August 10, 2007 and am doing well.  The Options Program is now only 12 weeks rather than 24 weeks. 
Hope this information helps.
              ObesityHelp Support Group Leader

 
It sure is good C'ING LESS OF ME!

 

We could learn a lot from crayons: 
some are sharp, some are pretty, 
some are dull, some have weird names, 
& all are different colors....but they

ALL exist very nicely in the same box.

 

(Author Unknown)

 

bookfaerie
on 9/7/10 11:21 am
 Thanks. I actually did that. Turns out I'm covered and have no copay for hospital stays. Who knew? 
Katrina F.
on 9/8/10 12:41 am - So.Cal, CA
Rock on, best of luck to you.
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