Looking for help.

pooker
on 12/16/09 10:43 am - Detroit Lakes, MN
My diabetic doctor referred me to a surgent for surgery i am 5'4"  227lbs..   I am on MNCare-Medica, Blue Plus..  My doctor is doing a letter that this is " medically needed"..  I am wondering if anyone else is on this and was able to have the surgery?
LynnMarie
on 12/16/09 11:38 am - South Metro, MN
I work for Blue Cross,  Blue Plus is a Blue Cross product, so you can't have Medica and Blue Plus.
Medica has a Choice Plus maybe that is what you have?  Anyway, if you are diabetic and your doctor recommends surgery you have a great chance of it getting approved with a BMI of 35+.
Good Luck 
Lalamommy808
on 12/17/09 8:42 pm - Burnsville, MN
I have no idea about Medica but if you do have Blue Plus, they will require you to go to a "Center of Excellence" for bariatric surgery.  I chose Park Nicollet's program at Methodist Hospital in St. Louis Park, MN.  The other option I was offered was Fairview Southdale Hospital in Edina, MN but after several other family members having bad experiences there (not bariatric related) I refuse to go there for so much as a papercut.

Call your health plan customer service.  It will be listed on your card and ask them about benefits for bariatric surgery.  They can detail all the things they require to approve it and get you pointed in the right direction for a doctor. 

Good Luck!

        
pooker
on 12/21/09 8:49 am - Detroit Lakes, MN
OOPS! 
I mean't Medica Minnesota Care, Basic plus...   I only have a $10,000 impatient Max.  I was wondering if anyone else had this plan and how it worked for them..  I am leaning towards the Lap Band..
Darla S.
on 12/22/09 12:24 am - Maple Grove, MN
I'm not a doctor, nor do I play one on tv, but I have this thought to share...

I was a Type 2 diabetic pre-op, and am no longer considered to be diabetic.  I had RNY.  I'm not 100% sure so anyone can feel free to speak up, but I believe that the RNY provides a greater chance of resolving Type 2 diabetes, in large part because of the malabsorption aspect of the surgery.  I read, when I was pre-op and researching my options, that in Europe, many doctors will perform they by-pass portion of the RNY without creating the tiny pouch, as a means of helping resolve diabetes in patients who don't need the weight loss.

So that's something to look into and consider.

Good luck to you!


  Imperfect does not = unsuccessful

lynnk
on 12/22/09 3:20 am - burnsville, MN
I was in the danger zone of being type 2 diabetic-not quite bad enough for meds but well on my way to getting them....I had MNcare then, bcbs and it was covered entirely.  I have had normal blood sugars ever since the surgery-not 'cured' according to my doctor, but at least well managed and not needing any medication.  a big plus!!!  check with medica on how they will cover it-and good luck.  it can be a crazy process but it is the best thing I have ever done for myself.
lynn

LynnK

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