changing insurance company to cover surgery?

bordfin
on 11/21/10 2:46 am
I am currently a federal employee with Kaiser (HMO) insurance. It has taken me 6mnths just to go to an informational session and now I am waiting for my first appointment and it won;t be for another 4months (Feb 2011) We have open enrollment right now and I have heard Blue Cross Blue Shield  Fed covers lapbad and or sleeve. Does anyone know if its true and does it take a year like with kaiser. This has been my second attempt with Kaiser its very restrictive and it takes a very long time.
Dave Chambers
on 11/21/10 5:02 am - Mira Loma, CA
I too have Kaiser, covered by CSEA in CA.  Kaiser is not really that restrictive to get band or RNY surgery, but may be for sleeve. I've heard they approve it, but not sure of current process. I speak with many people in the pre op process at support group meetings.  Each insurance company has rules on the process for getting wt loss surgery. They will vary with each insurance company and within each distinct policy plan.  Some plans may exclude wt loss surgery, or may have more restrictive policies than other companies.  Demand for the surgery also affects the time involved.  More people that want the surgery, the longer the waiting process.  I had surgery in May, 2006.  It took me about 10-11 months to get through the Kaiser process--getting my PCP to agree to surgery (advocate of the surgery due to co morbid conditions I had)--wait list for approval, waiting to get classes scheduled, getting appt. with surgeon, getting preop testing done, attending mandatory seminar and support group, and finally surgery.  So yes, it took me pretty close to a year.  It's likely as long if not longer today.  Changing insurance companies may take even longer to get surgery with another company. DAVE

Dave Chambers, 6'3" tall, 365 before RNY, 185 low, 200 currently. My profile page: product reviews, tips for your journey, hi protein snacks, hi potency delicious green tea, and personal web site.
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dutchgirl50
on 11/21/10 9:28 am - Ontario, CA
I also had my surgery with Kaiser in Fontana..You are one of the lucky ones, you only have to take a class for 12 weeks, I had to go for 6 months!  From my first informational class at Kaiser to my surgery was exactly 12 months, but well worth it...I would not change companies myself..you might have to wait even longer!  I know the year seems long..but once you have the surgery..time flies
Linda W.
on 11/21/10 12:45 pm - Clearlake, CA
I have Blue Shield. My very first informational seminar was in July 2010, My surgery was September 14, 2010. Barely 2 months from start to finish. I never even received a bill, since my max out of pocket had already been reached, thanks to a trip to the hopsital in February for chest pains. I had the RNY, BMI of 47 with diabetes and high blood pressure.
Linda    
acbbrown
on 11/21/10 11:18 pm - Granada Hills, CA
I have Kaiser (i'm in So. Cal) and it took me about 2 months from the time of referral by my doctor until the Options program started (12 week program). It seems like the length of time they want you to wait seems kind of long...

I was told that Kaiser does cover the sleeve - they also do RNY and lap band.
mrkbeatt
on 11/23/10 12:02 am - Glendora, CA
I started in april of this year with Kaiser and on decumber 10  I will have my surgery so it has been 8 months for me Kaiser covers the Lap Band,  Sleeves and RNY.  But stay on them and see if there is a class that is off the beat of every one else.

the class I took was at a time before  other people where still at work  so check on other classes and pu****
Jean in the I E
on 11/23/10 12:48 am - Fontana, CA

I have Kaiser and had my sleeve done 15 months ago. They cover all 4 surgeries but primarily do RNY and VSG. My opinion is to stick with Kaiser because you would have to start all over again with all of the required prerequisites if you change insurance and your wait will be much longer. February will be here before you know it and the Options classes are only 12 weeks (I went for 24 weeks).

Good luck...

Jean  I'm 45, 5' 4-1/2" -- 315/272/230 -- 43 lbs lost pre-op
"Progress, not perfection..." ~Dr. Roger Gould
Breast reduction & lift - 11/11/11 (sooo wonderful!!!)

Deb B.
on 11/30/10 6:55 am - East Bay Area, CA
I have kaiser in the SF bay area. 
I went to the orientation and never had to do any 'options' class.
From the time I went to the orientation to surgery was 4 months.
I am very pleased......had no deductable at all...costs me more to just go see my doc for a cold than the cost of surgery ($0) and the after care has been great in my experience.
I dont think I would jump ship just yet.  Go in Feb and see if the process doesn't start moving a bit quicker.  When I had mine in Sept 2009 I was offered the sleeve as they had just started doing it.  I opted for RnY though.
Good Luck

Debbie
            
MacMadame
on 12/1/10 1:23 am - Northern, CA
Most other insurance companies don't take as long as Kaiser. It can take as little as a month, in fact. But this is only if they don't require you to do a 6 month medically supervised weight loss program first.

This is something to be sure to ask about before you switch!

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