health link ins

I am a state of Illinois employee w/Healthlnk Ins.  I have called them three times asking what prerequisites there are for WLS.   They keep telling me a letter of medical necessity from Dr.  I went to Surgeon last week.  Surgeons nurses keep telling me they think I need a  6 month diet history with Healthlink.   They keep acting like they don't want to send the letter until I do the diet.  I just insisted they send the info to the ins. co.   Is there anyone out there with this insurance?  What is your experience.  I have asked a couple people here at work and they say they didn't have to do the diet.   I'm just wondering if they had more info to send to ins. co. or If the Surgeon's nurses are inexperienced with this ins. which I find hard to believe since they are here in Springfield where there are so many state workers.   What would you do?

Have you asked the Ins. if they require a 6 month supervised diet? I did not have to do the 6 month through BCBS but most ppl do!

 

Karen

Welcome to OH Illinois!

Post this question on the lapband board. There is a lady named Vicki (the insurance guru) there who knows a lot about insurance. Maybe she will be able to help.

Keep coming back here and post on the daily roll call so you can get to know the rest of us while we get to know you. You will find a lot of support and friendship here. We are all in this toogether!

 

 

I am a state employee with Quality Care--Cigna and they required the six month weight loss. And you had to go each month. If you missed a month by even one day you had to start over, so get the requirements in writing from Healthlink.

Connie 

Smilin here is the link so the medical policy with Healthlink for weight loss surgery guidelines.  If you have any questions just let me know,

http://medicalpolicy.healthlink.com/medicalpolicies/policies /mp_pw_a053317.htm

Hey Vicki, thanks for popping in...how are all those grandkids doing?

Actually Carol I havent seen them for the past 2 days.   They live across the street from us but their church is having Vacation Bible School this week and my daughter and son in law are teaching a class so the whole family has been at VBS and when they get home by 8:30 or 9:00 she is so tired and fighting to get all the kids something to eat, bathed and to bed.  Little bit (nysiah) they have been leaving her with my sil's mother cause she just lives across the street from t he church. 

B ut we saw them Sunday after church for a little while.   

Thanks for asking you know they are the loves of my life.

Vicki,
Thanks for the link I have added to favs so I can read and decipher a little at a time.  The problem is the ins. customer serv. rep. is saying it isn't necessary while the surgeons office is saying their experience it is needed.   I think I will go ahead go to my pcp this month which will make 2 months in a row about my weight by then I should of heard from ins. weather they will approve me or not.  Most I might of wasted is a co-pay and a couple hours and if it is needed then I will be a third of the way there.

Sorry I am late with this.  I have healthlink through the state of Illinois, and all I needed was a letter of medical necessity, no 6 month diet.  PM me if you have nay questions.

Dee

Dee,
Thanks for your response it reassures me that maybe the surgeons office may be confusing healthlink with health alliance which are both offered to state employees.