MVP (POS ) INSURANCE ?? has any one had this?? In the Capitol dist area??

I just got my MVP (POS) plan and called MVP(regarding WLS) & they say I need co-morbititys and approvaL for surgery... MY Dr is writing a letter of medical necessity and my BMI is 47 and my blood pressure is high, and I am hoping that the fact that all the woman in my family have diabetes & one died from diabetes is enough.. Has any one had MVP (POS) plan?? I am so nervous ! I need this surgery! I weigh 255 lbs ! rae

really glad I asked for advice on this board MMM makes ya think...

Rae: The advice I give anyone on insurance is CALL YOUR INSURANCE COMPANY ask for a COOY OF YOUR POLICY in regards to BARIATRIC SURGERY, you want to know what TYPES of surgery are covered, some cover only RNY, others the band and some the BPD?DS but many arenot covering all. No one can tell you what YOUR policy covers even if you and I had same insurance our employers policy and riders may be very different, this is because each employer buys a package from a company so no two policies are alike usually, so my or others experience is not helpful in the least quite honestly. For bariatric surgery a BMI of 40 or a BMI of 35 + 2 major medical comorbidities (such as sleep apnea, cardiovascular disease like high BP, elevated lipids, diabetes, etc) is necessary. Ususally your BMI of 47 will be enought but again it can be indiviudal. So give them a call, ask if your surgeon, hospital and surgery type are covered under YOUR PLAN and then ask for that in writing as well as the exclusion criteria and the criteria that you must meet to be a candidate for bariatric surgery. Better to find out now then when surgeon files for approval and you discover he ir the surgery type or hospital he practices at isn't covered etc. Sometimes people do not answer post because they are busy or they simply do not have the answers, consider reasking again as that may get attention a different day, it isnt always a sign people do not care. I wanted to answer this days ago I just have simply not had the time to do so. Be well. and let us know what you find out! Take Care, Jamie 100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY 320(preop)/163 (lowest)/174 (current) 5'9'' (lost 45# before surgery) Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com http://www.obesityhelp.com/member/jamiecatlady5/ "Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"