CAN SOMEONE ANSWER QUESTIONS ON INSURANCE
HELLO: I'M TRYING TO GET REVISION SURGERY TO A 18 YEAR OLD RNY BYPASS. I'M LOOKING FOR ANYONE WHO HAS HAD A REVISION AND WAS COVERED BY PRIVATE INSURANCE. NOT MEDICARE/MEDCAID OR EMPLOYER PAID HEALTH. JUST A PRIVATELY HELD POLICY THAT COVERED REVISION? PLEASE, THIS IS VERY IMPORTANT THANK YOU. JROLFSON
(deactivated member)
on 3/8/08 4:15 am, edited 3/8/08 4:16 am
on 3/8/08 4:15 am, edited 3/8/08 4:16 am
At the top of this page you'll see "forums"..move your mouse on that and then at the bottom of the list you'll see "more forums." Click on that and that will take you to the main forums page. Then you'll see a section called "weight loss related forums." Scroll down in that box and you'll see (alphabetically listed) a forum for insurance. OR you can just go here www.obesityhelp.com/forums/insurance
I do health insurance filing and precerts for a living for a PCP MD. It is hard now to get approved but do not get discouraged it can be done. Write a letter to you Insurance company explaining why you feel you need the procedure and what changes it has already made in your life. I have helped people get approved through BCBS, MedCost, But Cigna has clauses in there policies and very few approvals here in NC. The best thing to do is find someone close to you at the PCP or surgeon who will help you get approved. It helps to list issues before weight loss and after weight loss and why you feel this will only help in this journey. Also get PCP and Surgeon to write on if they will. BCBS I have found is the most resonable one to deal with in NC. Who do have insurance with now and have you tried anything yet to get approved.
Robin B
Thank you for your reply. I currently have BCBS of Utah. They have an exclusion in their policy for any kind of WLS or procedure including revision. It's pretty black and white and I've heard they don't budge. But I have picked up a supplementary policy with United American Healthcare. The administrator tells me they don't have any exclusions for WLS as long as it is deemed medically necessary. So I'm going to try it in a couple of months. I don't hold out a lot of hope because I've been down this road before.
Thanks so much again.
JRolfson