Humana Ins. State Employee

New here and have been lurking. I have Humana Insurance, when calling to obtain benefits I was told I would need to have surgery at a COE. Drs office is saying I can have surgery anywhere as long as the surgeon is a COE surgeon. Anyone have any information or suggestions? Any one else have the state Humana that has had this surgery?
Thanks
Cyndi in KY

I have Humana Commonwealth and had my Realize Band on June 25, 2009 at Jackson Purchase Medical Center in Mayfield, KY.  I do not believe it is a COE since Medicare patients have to go to Georgetown to have their surgeries.
I got approval within a week of my surgeon's request.  I followed a 6 month dr. supervised diet plan and followed the other requirements that Humana has.  I suggest calling them and enrolling in Active Health's Why Weight Kentucky.  You talk to a nurse about weight loss and your goals.  You also get appetite suppressants your dr. prescribes covered by the plan.  I am not sure if this helped my approval or not, but I am sure it didn't hurt.

Hi Cindy,
I have Humana PPO through the state also.  I had the realize band On June 8, 2009.  I had called last year inquiring about the coverage of weight loss surgery.  They told me about the supervised weight loss requirement, bmi numbers, etc.  They did not mention the COE part but ultimately I went to Dr. Sonnanstine who is a COE surgeon so it may have been a non-issue.  They also told me that Weigh****chers would work if you could document that you attended the classes and tried.  When I talked to them I wrote down who (the operator name) I talked to so I could document who told that Weigh****chers would count for the supervised weight loss program.  After they submitted my paperwork to the insurance I was approved within a week.  The insurance never did ask for proof of my attendance at Weigh*****chers.  I did join the Active health program.  I talked with a representative on the phone about goals and plans to accomplish those goals.  If you have any other questions you can send me a message.

Happy hunting,
Valerie

I too have Ky State Insurance with Humana, I didn't have it until Jan. 09, I was on my husband BCBS and it wouldn't pay for it.  I took my insurance back out and knew that I had to do the 6 month diet,   I had my surgery with Georgetown and Dr. S on July 8th, no problems and no questions asked.  It all was smooth sailing.  Dr. S is great you would love him.  

Renea

I am a retired Kentucky teacher and have the Humana state employees insurance too.  I had my surgery at Louisville's Norton Suburban Hospital - Dr. Shina.  I wasn't asked anything about a Center of Excellence, so I suppose it is one?  Good luck!

After walking the halls at Norton Suburban Hospital (twice in 2 weeks), the plaque on the wall says they are a Center of Excellence.  I had Dr. Shina and would reccomend him for this surgery to anyone.  He took good care of me and the surgery was a success.  He is in Louisville.  He also does surgery in Charlestown Indiana.

Vera-Ellen   

Humana State employees insurance does NOT require a COE.  Georgetown is a COE and is a wonderful hospital for bariatric surgery.

Sharley