John Deere of TN???

Hello, I am new to the site and am in the process of getting bypass surgery. My insurance is with JOHN DEERE HEALTH, INC.- Select, POS.-the state of Tennessee is my employer. Does anyone have any information on this insurance company's approval record? I have heard they are really good from various people about approving WLS. Any info. would be greatly appreciated. Thank you, JOE P.

Well, Joe, the state of Tenn is also my employer and I have the exact same insurance. I was just denied last week!!! When I called them last May, they told me I had to meet the six months supervised diet requirement, psych evaluation and so on and so on. Well, I did all that for six months. I gathered up my medical records all the way back to 1970. They got 27 pages of medical documentation and supporting documentation for my co-morbidities. Guess what? That wasn't enough. They sent me a fax with their requirements on it and I checked off everything as I went making sure I had it all completed. NOW, they are saying they denied me because the "state" NOT John Deere says I have to have two consecutive years of a physician supervised diet plan and lose 10% of my body weight to qualify. At no time in the past was this ever mentioned to me. They also informed me that even though I was taking diet pills as part of a physician supervised diet plan, they won't count that in my medical history because diet pills don't count. So, right now to be quite honest, I think John Deere is pathetic!!!!! I am so mad at them for letting me believe that all I had to do was meet the six month requirement and get all the other test done and then flat out denying me my surgery. I am going to appeal it and see what I can get done from there. You better do some intensive questioning when you contact them. Good luck!!!!

Hey Joe, Just wanted to let you know that I finally found someone at John Deere that was able to help me out a little with the criteria required by the state. Go to www.state.tn.us/finance/ins/spd04/pdf then do a search on the word bariatric. It will take you to page 94 which will then give you the criteria for the state of Tennessee. Hope this helps you. I'll be glad to share my info with you as I go along.

Hi Joe, I also work for the State Tn, I was told that the St has different plans for different companys like teachers, St Hospitals etc... I don't have John Deere. I have BC/BS PPO and it had it's own requriments other than BC/BS I was not told it was a nightmare!! Even the people I talked to at BC/BS didn't know. But it all worked out just stay on top of it! My advice contact your HR and ask for a phone number to call direct to JD.Some people I work with who have JD had no problems. Best of luck and Happy Holidays Linda

Linda, Thank you for your reply. I am nowhere near the point of sending in paperwork to insurance company yet. BUT....I hear only GOOD things about John Deere...so I feel good. I have only heard one negative reply, and that was due to the person not being on a "medically supervised" weight-loss plan for six months in the last year. I have been on one way longer than that whi*****ludes a prescription weight-loss drug that is controlled by the state an has to be re-written every month by my doctor for a refill. I have talked to John Deere, and they told me their requirements, but I had heard about the discrepancy as well between the state requirements and John Deere. However, I spoke with my surgeon's office, and the lady that handles it says to just sit back and relax, they know all about fighting with the insurance companies..and that John Deere is one of the better one's when it comes to approving the surgery and paying for it. So, I hope when that time comes, I am one of the lucky ones. I am getting all my ducks in a row beforehand. My psych evaluation is in January...then all the paperwork to the surgeon's office for submitting to the insurance. Time will tell...keep your fingers crossed. I just wish I had a guarantee...ya know? thanks again, JOE