Too good to be true???

Ok so I went to the seminar last night with Dr. Kligman. I thought he was terrific. I am very excited for him to be my surgeon. Anyway, he gave us the procedure codes for us to verify with our insurance company. I called mine just now and they told me I need a referral from my pcp and a letter from him stateing that the procedure is medically nessessary. I said ok, is there any other requirement besides the letter. She said no. I'm just thinking this can't be true. I've heard other things including having to go through a 6 month supervised diet. Do you really think all I need is that letter from my pcp?? Sounds too good to be true to me.


~Danni~

Depends on your insurance.

all we needed was the surgeon to ask for it.  we both had BMI over 40... approval was easy...

the hoops we jumped through were for the surgeon.

You didn't have to do the 6 month supervised diet?


~Danni~

nope....  no supervised diet, no weight history.

the SURGEON required 3 months... but our insurance required NOTHING but being fat and wanting the surgery.

Wow, this is great news for you. I hope you have smooth sailing. Good luck.


                                                                                         Julie

What each surgeon requires is different.....but its what your insurance requires that may be a hurdle. Just check with your insurance company.

I did. That is what the insurance company told me.

my insurance company was the same as well. i just needed to submit basic things like what yours requires. it really depends on the level of insurance you have and the company. my new insurance sucks so glad i did it when i had great insurance.

Nicole you bring up a good point. If you end up changing insurance in the future, how does that affect your post op check ups? Is the new insurance gonna cover something like that? I never even thought about that until now.

~Danni~

My insurance covered all post op checks for the first 90 days after surgery.  My surgeon's office had a program fee ($1,000) that covers all other post op checks for 3 years after surgery - those include Nutritionist, Behavioral Evaluations, and an exercise specialist - which are not covered by my insurance (I have BCBS).