State of Minnesota Insurance Options: BCBS, HP or PO?
I figured I'd put this in a separate post, as it is only somewhat related to my first post regarding surgery and pregnancy.
Does anyone here have experience with state of Minnesota insurance and the requirements for bariatric surgery? I am a state of Minnesota employee currently under Blue Cross Blue Shield (BCBS)coverage. From what I have learned BCBS requires you to do a 6 month weight loss program with your physician, including visits once each month, before you can qualify for the surgery. This seems to mean that you cannot proceed with the other prerequisites until you have completed the weight loss program. Although I have tried numerous weight loss programs including Weigh****chers, Atkins and going to the Emily Program I don't think any of these count because they were not technically doctor supervised.
HealthPartners seems to have a little less strict requirement only requiring you to finish their Call to Change program and do the usual psych evaluation. I can't find any information on PreferredOne and their requirements.
With my open enrollment coming up, I am contemplating switching from BCBS to another provider that might help me have my surgery faster. Can anyone help me answer some questions I have?
Does anyone know anything about the differences in the plans?
How long does it take to go through the pre-op process for each of the plans?
Does BCBS strictly adhere to their pre-reqs or would they consider waiving them?
Does anyone have insight into their experience with these three plans?
Thanks so much for any help you can give!
Shannon
Does anyone here have experience with state of Minnesota insurance and the requirements for bariatric surgery? I am a state of Minnesota employee currently under Blue Cross Blue Shield (BCBS)coverage. From what I have learned BCBS requires you to do a 6 month weight loss program with your physician, including visits once each month, before you can qualify for the surgery. This seems to mean that you cannot proceed with the other prerequisites until you have completed the weight loss program. Although I have tried numerous weight loss programs including Weigh****chers, Atkins and going to the Emily Program I don't think any of these count because they were not technically doctor supervised.
HealthPartners seems to have a little less strict requirement only requiring you to finish their Call to Change program and do the usual psych evaluation. I can't find any information on PreferredOne and their requirements.
With my open enrollment coming up, I am contemplating switching from BCBS to another provider that might help me have my surgery faster. Can anyone help me answer some questions I have?
Does anyone know anything about the differences in the plans?
How long does it take to go through the pre-op process for each of the plans?
Does BCBS strictly adhere to their pre-reqs or would they consider waiving them?
Does anyone have insight into their experience with these three plans?
Thanks so much for any help you can give!
Shannon
Hi
BCBS is what I have as well, and the 6 month "structured weight loss" is something you HAVE to do. But it all counts - once you select your surgeon, the clinic knows how to schedule your visits to meet the requirements. Mine started from 1st visit and before I knew it, I had met everything and had my surgery date. The time goes by very quick. I had the Psych - nutritionist - bariatric doctor - and surgeon all in the 6 month period. It works quite smooth, they specialize in this and know how to help get you through it all. Don't choose based on shortest wait - choose based on who offers you the BEST coverage - because 6 months is so totally worth it!!
Good luck on your journey - it is a wild ride, but a GREAT ride!
Kelly
BCBS is what I have as well, and the 6 month "structured weight loss" is something you HAVE to do. But it all counts - once you select your surgeon, the clinic knows how to schedule your visits to meet the requirements. Mine started from 1st visit and before I knew it, I had met everything and had my surgery date. The time goes by very quick. I had the Psych - nutritionist - bariatric doctor - and surgeon all in the 6 month period. It works quite smooth, they specialize in this and know how to help get you through it all. Don't choose based on shortest wait - choose based on who offers you the BEST coverage - because 6 months is so totally worth it!!
Good luck on your journey - it is a wild ride, but a GREAT ride!
Kelly
http://www.TickerFactory.com/weight-loss/w2Fm5C4/">
I was on a federal plan so my experience may vary. I started with Health Partners, but was unable to get all of my ducks in a row before the December changeover season. HP rates (for me) went out od sight in comparison to other plans.
I changed to BCBS On Jan 1, I did have all of my HP requirements done, but had to take extra sessions with the Psychologist. On my transfer, I called BCBS and they stated I might have to restart the process, but as it worked out, because of the fact I transferred over, I was exempted from the extra six months, and I had enough documentation of past diet attempts to cover trying a new one. I ended up having surgery on Feb 15!! I wasn't concerned about needing to "diet beforehand because my surgeon told me how much the initial weight loss PRIOR to surgery helped him do his task (because the operattion is under the liver and the initila weight loss comes off the liver first.
Start practicing some of the RNY guidelines, such as protein first, no drinking before or after the meal for a time AND what helped me most was journaling every food item and exercise done through the day. You will gain a better understanding of where you are and what each food item represents to your body.
Remember, even this surgery is a diet and exercise program to get you healthy and feeling better.
I changed to BCBS On Jan 1, I did have all of my HP requirements done, but had to take extra sessions with the Psychologist. On my transfer, I called BCBS and they stated I might have to restart the process, but as it worked out, because of the fact I transferred over, I was exempted from the extra six months, and I had enough documentation of past diet attempts to cover trying a new one. I ended up having surgery on Feb 15!! I wasn't concerned about needing to "diet beforehand because my surgeon told me how much the initial weight loss PRIOR to surgery helped him do his task (because the operattion is under the liver and the initila weight loss comes off the liver first.
Start practicing some of the RNY guidelines, such as protein first, no drinking before or after the meal for a time AND what helped me most was journaling every food item and exercise done through the day. You will gain a better understanding of where you are and what each food item represents to your body.
Remember, even this surgery is a diet and exercise program to get you healthy and feeling better.
My insurance is thru my husband and we have BCBS and he is also a state employee. I went to the seminar and met with the surgeon that same day which was July 10, 2009. I had my 6 month supervised wt loss program with the clinic and met with the psychologist in october. Had my surgery in December on the 22nd. I think the Univ of MN program was/is awesome. Great pre/post op services. The 6 months goes quickly. BCBS is strict, and the surgery coordinator at the clinic helps you get thru all the hoops.
Best wishes on your journey. Email with any further questions.
And do like Paul says. Anything you can do behavior wise to modify your behavior before the surgery helps with post surgery eating.
Carol
Best wishes on your journey. Email with any further questions.
And do like Paul says. Anything you can do behavior wise to modify your behavior before the surgery helps with post surgery eating.
Carol
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