ins question...help!!
let me start by saying, i started this journey about 4 years ago (or more) and, due to bumps in the road, and life in general, i had to put things on hold. now im back and ready to get this done!!!!
when i first was trying to get the surgery, you were required to jump thru so many hoops and i just could not coordinate and commit to it at the time. now, this is my time and im going to get it done no matter what!!!
i have health new england and i live in the springfield, ma area. i am waiting on the actual packet frm the ins co to come in the mail but over the phone they said that the requirements for approval are:
bmi of X-X with no co-morbids OR bmi of 35 with 2 co-morbids
6 mo supervised diet
nutritionist
physc eval
it doesnt say anywhere that i have to show 5 yrs of medical records/previous weight loss attempts. sooo is it not required by my ins? just curious bc im trying to get all my ducks in a row. seminar w office in feb but any info would be helpful..thanks
when i first was trying to get the surgery, you were required to jump thru so many hoops and i just could not coordinate and commit to it at the time. now, this is my time and im going to get it done no matter what!!!
i have health new england and i live in the springfield, ma area. i am waiting on the actual packet frm the ins co to come in the mail but over the phone they said that the requirements for approval are:
bmi of X-X with no co-morbids OR bmi of 35 with 2 co-morbids
6 mo supervised diet
nutritionist
physc eval
it doesnt say anywhere that i have to show 5 yrs of medical records/previous weight loss attempts. sooo is it not required by my ins? just curious bc im trying to get all my ducks in a row. seminar w office in feb but any info would be helpful..thanks
Your insurance sound exactly like mines. Just a tip: Meet with your PCP as soon as possible, ask him for a letter stating that WLS would be in your best interest bc you will need clearance from him. Also ask for your previous medical history including weights. When u pick your surgeon forward this to his office. This can take a while so its best to do it now. It held my surgery date for over a month because I had to wait for m darn PCP to get the info to my surgeon's office. The surgeon uses all this info to give to your insurance company to persuade their approval.