Insurance Help

Hi, I'm new here... I have been interested in the gastric bypass for years now. Since I was 15. Over the years I've learned much about the surgery, but have never come across much information on insurance... I turned 19 this month, so my insurance has ended. Honestly, I have no clue where to start looking for an insurance plan. Sacred Heart Hospital (Pensacola, Fla) has a weight loss surgery program, and I have just now started becomming active in calling around desprately to find out what I need to do, and trying to find out on my own how to get things done. It's really not easy. I guess I was hoping someone could give some advice. I do believe it would be much easier to pay out of pocket for the surgery but that's not an option for me. So insurance is my only hope, and honestly no one really can give me much answers (and any no one, I mean the professionals that I speak to). So, is there a certain insurance I should look into? One that is weightloss surgery friendly? Very friendly? Thanks for reading this, and for any responses/help/advice/support I may get. Frances Lynn

Frances Lynn, I would suggest United Healthcare, they have been the easiest to approve that I have seen. I would look into companies that offer United Healthcare as part of their benefits plan. The best of luck to you sweety, I know exactly how you feel. Amy

Did you lose your insurance because it was your parents coverage and you are no longer a student? If you enrolled in college classes could you keep it? Even community college where you would get financial aid to cover most of tuition. Then you would building your future and be able to get your surgery....just a thought! Sarah

Hi Frances Lynn, I work with pre-certification at my bariatric office. I recommend finding the doctor of your choice first. Find out who they accept, if any. If they are out of network, *that* is critical information. No matter which company you select, in this example they will have to have "out of network benefits for the medically-necessary surgical treatment of morbid obesity" for you to have a covered benefit. Which procedure do you want to have? The office you select can provide you with the procedure or CPT code - use it to ask the company if the plan you are considering covers that procedure code. The single most important thing you can do right now is to make an appointment wit your PCP *now* to start a physician-supervised diet and exercise profram. Make sure he/she documents your: vitals, including height, weight, and BMI; diet plan you will follow (low fat? low carb? etc.); type of exercise you will do (bike? swim?); and frequency (5x per week for 30 minutes each day). Also discuss behavior modification and even diet pill use. Make sure that this *entire* discussion is documented each and every month. You see, most insurance plans these days require a physician-supervised diet of some length. Get that going now, and you'll be ahead of the game when your new policy kicks in. HTH, Kristen

One note on United, I have that insurance but WLS is excluded. Make sure you check VERY VERY carefully to see if WLS is excluded. Call around to the different insurances. I think Cigna has the same exclusion. I've heard people had luck with Aetna, but check around, everyone has a different story. Shannon