Who is your insurance provider?

hello all, I was wondering if you all could tell me who your insurance provider is and what all you had to do to let them insure you.  I would especially like to know if you had no prior medical conditions and were able to get insured.  I am 23 but I don't have diabetes and I haven't really been on a perscription diet except for like a month or two.  My mother says it smuch easier now to get approved but I still think becuase of my age and lack of conditions they will not pay for it. What do you all think? 

I have Tricare. No prior medical conditions like diabetes or anything. I do have PCOS. no thyroid condition. No prescription or supervised diets. I dieted on my own and used that. I just had to meet with the surgeon and then see the pysch and nut to see if I was depressed and then to make sure I understand what is going to happen to me. I got approved right away. Before I did anything, I checked with my insurance to see their guidelines regarding weight loss surgery and then I checked the guidelines for the hospital I am going to.

Are you asking about getting insurance or about insurance requirements for approval for surgery? Of course people who have had no illnesses will have an easier time getting (buying) insurance, that just makes sense.  But if what you are asking is if having no co-morbidities makes getting insurance approval more difficult -- then that depends on your policy.  You should be able to call your insurance carrier and ask what the requirements for approval are.  In some cases you can even look up this information on line. Red

Rktimar, I live in Florida and my insurance provider is Vista Healthplan.  I had the lapband in August of 06 and my husband had it in February of 07.  He was approved really fast, but like you, I have no co-morbidities.  I documented my diet history...weigh****chers, atkins, south beach, etc.  I've never been on a medical diet either, but have tried many diets and centers.  My approval took about a month.  What qualified me was my family history, diet history, being 100 pounds overweight, and my BMI of 45.  Vista's guidelines are that you must be 100 pounds overweight, with a BMI of at least 35 with no co-morbidities or a BMI of 30 with at least 1 co-morbidity.  I only paid 250 for a private room, and my 10 copay each time I visit my surgeon for a fill.  Good luck finding a provider.  It is definitely worth the work and wait.

Hello,

Not sure if your question is which insurance to choose or if you already have insurance. I'll use an illustration that I use at information sessions. I tell potential patients, "pretend that everyone in this room has UHC, for example. Unless you all work for the same exact employer and purchased the same exact policy (HMO v. PPO, for example) then you can be guaranteed that everyone in this room has a different benefit for weight loss surgery."

That being said, most insurance companies - but not all - require at least one co-morbid condition in addition to a qualifying BMI. Which co-morbids and which BMI? That too is up to the insurance company. *Most* of the time you can look up the clinical policy bulletin information online but do bear in mind that your specific policy *may* be different. My best advice is to go have a thorough physical with your PCP. You may have GERD or even sleep apnea and not even know it.

Another good bit of advice is to get on a physician-supervised diet and exercise program ASAP. Most insurance companies require this, so there is no time like the present. And even if you don't need the diet to get approved, at least you can lose some weight preop so that surgery and anesthesia is safer.

Back to your original question. I had Aetna, and satisfied all of the pre-d requirements listed here: http://www.aetna.com/cpb/medical/data/100_199/0157.html
But, I had to sue Aetna because they felt that I hadn't met the requirements.

HTH.

I have Aetna HMO.  I get covered through my benefits plan at work (they do not ask health questions).  I am 24, I started at 125lbs overweight and have no co-morbidities.  My ins requires a bmi of 40 or higher (or 35 with a co morbidity), a 3 month dr. supervised diet/exercise plan, and documentation of my weight for the past 5 years.  My dr asked me to provide a listing of the past diets I've been on, and how much weight I lost/gained back. My friend from work has Cigna PPO and she said they also had the same bmi requirements but she had to have a 6 month supervised diet/exercise plan.

I was thinking about dropping my UHC insurance that I get from work and buying another insurance that cover WLS.  Does that sound crazy??