Tufts HMO: Any advice on getting approved
Thank you Patty for your help. I know that they cover bariatric surgery. I am 22 yrs old and have no co-morbidities. I have severe joint pain, and must take pain meds daily to just be able to walk comfortably. This has come about in the past month. I am a nursing student at Umass, Amherst and have trouble walking around campus. I am easily short of breath, and have recently had a lot of heart burn. I am afraid that Tufts will not cover the surgery because I am so young, and I am covered under my mother's insurance since I am a student. I am 5'2 and weigh 253 so I have a BMI of around 46-47. I know that everyone's cir****tances are unique. I was hoping for some information as to whether or not Tufts likes to fight people about surgery, or if they are pretty easy to deal with, with regard to this issue. Any assistance will be greatly appreciated. Thank you again.
Courtney
Hello again Courtney
I think you need to do your evaluation and be tested for GERD and Sleep Apnea. I didn't know I had sleep apnea either.
Here is the link with all the criterias for Tufts WLS
http://www.tuftshealthplan.com/providers/pdf/medical_criteria/obesity-adult-surgical_treat
ments.pdf
Let me know if I can be of further assistence.
Take care and good luck!
Thank you Virginia, I'm so happy for you that your surgery is Monday. I am a nuring student at Umass, Amherst and I have done extensive research. I originally wanted lap band until I heard of so many people not losing weight. I know that many do, but I am a very unlucky person and I don't want to go through surgery just to find out I'm not going to lose. This is just how I feel. I don't want to deal with the fills either, or having that foreign object in me. I am glad that you are happy with your choice and that it is right for you, I think it is not for me though. I like the fact that gastric bypass was around long before I was born, and there are people on here that had it done in the 1970s that have kept the weight off, lap band is much newer, and long term outcomes are not yet known. Good luck with your surgery and I wish you the best.