Desperate need of advice w/ WLS! PLEASE HELP!

solshove
on 1/7/16 6:38 am - Cincinnati, OH

I am 26 years old currently reside in Cincinnati and I am in the midst of a research storm with bariatric surgery. I have decided to have it and have already met with Dr. Trace Curry, but I am "shopping around" and looking up other surgeons, as well. The battle I am having is with insurance. I am also looking for an individual plan(self insured) as my employer does not offer benefits. Everywhere I have looked, both Anthem BCBS and Humana claim to cover weight loss surgery. Yet, when I speak with a rep, I am told no. One person I spoke with at Humana said they do cover it, if it is medically necessary. Of course our call got disconnected. I called back and spoke to 3 others, 2 of which could not give me and answer and the last one having to jump through hoops to get me an answer. I spent 3 hours on the phone last night, and that was just last night.

I am self sufficiant, therefore don't have the money to pay out of pocket upfront, and would most likely take me 5-10 years to pay off, even though I am starting to lean toward this option. Is there anyone out there who can lend me some advice, help and/or guidance? I am beside myself and not sure what to do from here.

I never knew it would be so tough to regain my health and my life.

DEBGG
on 1/14/16 2:23 am

I am going to the Cleveland Clinic and they have people who actually take care of this for you. I suggest trying to find a surgeon who strictly deals with these types of surgeries and has a team to help you. Good luck!

MRSYOGI1005
on 1/22/16 7:54 am

I am insured by anthem bc/bs. Although my surgery was 8 years ago, they did cover all but 100.00. I don't know if there is a waiting period as far as if it new insurance or not. The only waiting period I had was required by my surgeon. It was 4 weeks of classes 1 a week for 4 weeks. That you have to pay for out of picket. It is still 100.00 for the classes. Most ins. Companies that cover it will want a letter from your dr. Saying that you are at risk of several comorbities and what have you tried already to get the weight off. 

I had to go to the meeting the drs have for those interested in WLS. I went to my meeting in may and was approved and had my surgery on Sept 17th, 2008. 

FYI

My doctor is Bradley Needleman out of OSU hospital in Columbus Ohio. He is very busy a great dr. Seems like I'm always meeting someone who had him for their surgery. 

jmay86
on 2/23/16 1:22 pm
VSG on 03/03/16
On January 22, 2016 at 3:54 PM Pacific Time, MRSYOGI1005 wrote:

I am insured by anthem bc/bs. Although my surgery was 8 years ago, they did cover all but 100.00. I don't know if there is a waiting period as far as if it new insurance or not. The only waiting period I had was required by my surgeon. It was 4 weeks of classes 1 a week for 4 weeks. That you have to pay for out of picket. It is still 100.00 for the classes. Most ins. Companies that cover it will want a letter from your dr. Saying that you are at risk of several comorbities and what have you tried already to get the weight off. 

I had to go to the meeting the drs have for those interested in WLS. I went to my meeting in may and was approved and had my surgery on Sept 17th, 2008. 

FYI

My doctor is Bradley Needleman out of OSU hospital in Columbus Ohio. He is very busy a great dr. Seems like I'm always meeting someone who had him for their surgery. 

Not to get off topic, but my upcoming surgery (3/3/16) is with Dr. Needleman, so I'm glad to see someone happy with his results!

MRSYOGI1005
on 1/22/16 3:20 pm

I am insured by anthem bc/bs. Although my surgery was 8 years ago, they did cover all but 100.00. I don't know if there is a waiting period as far as if it new insurance or not. The only waiting period I had was required by my surgeon. It was 4 weeks of classes 1 a week for 4 weeks. That you have to pay for out of picket. It is still 100.00 for the classes. Most ins. Companies that cover it will want a letter from your dr. Saying that you are at risk of several comorbities and what have you tried already to get the weight off. 

I had to go to the meeting the drs have for those interested in WLS. I went to my meeting in may and was approved and had my surgery on Sept 17th, 2008. 

FYI

My doctor is Bradley Needleman out of OSU hospital in Columbus Ohio. He is very busy a great dr. Seems like I'm always meeting someone who had him for their surgery. 

wandak
on 2/24/16 3:00 pm - lexington, oh
RNY on 01/05/16

I have bcbs too and I had to pay 2200. out of pocket it depends on your plan. I go to Dr Sonnanstien in Columbus surgery was done at Riverside.

 

Wanda

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