New member

Hello everyone. I am new to the board. I have been a member with OH for awhile but never posted. I have just recently completed my 6 months of seeing a dietician. I have all my paperwork together and it is being sent to my insurance for authorization. I live in Menasha, Wisconsin and if approved I will be having surgery at ThedaClark in Neenah. I have BadgerCare - United Health HMO. I have been diagnosed with morbid obesity with a BMI of 43 and depression. Has anyone used them in the past as their insurance for surgery and if so how long was the approval time? They said as long as it is medically necessary they cover it. Keep your fingers crossed for me and to all of you who have a date scheduled for surgery, are waiting to hear from your insurance company, or are just starting the process good luck and congratulations.  Happy Holidays to you all. Amy

Hi, I just went to the reequired seminar for WLS last night.  I have appt. to see Dr. Jan. 14th.  I am new to all of this.  I was told with Badgercare, which I also have I need to see dietician for 6 months.  As long as surgery is medically necessary why do we have to do this.  I have arthritis in my knee and was told by Dr. that lossing weight would help, nothing else has so far, and I have tried nearly all the medical treatments.  I was so discouraged to hear the process will be another 6 months with the dietician added onto the already 6-12 process. Beth

Beth, The reason why they want you to see the dietician is to make sure that you are learning to eat better and show that you can follow the diet that they recommend. I was the same way when I found out that you needed to have 6 months with a dietician but the time actually went by really fast. They pretty much want you to cut out all carbs and soda and eat lots of protein. Don't get discouraged. Time will go by fast for you too and in no time hopefully you will be scheduling your appointment.  Amy

Hello Amy,

My name is Cindy I am new here too.  I have doctor Wasco, and live in Neenah.  I have all my necessary paperwork done, but failed the Psych eval.  So I am waiting for 4 months or so before he would reevaluate me.  I have my fingers crossed for you, for sure and will say a prayer or two.

I have medicare and Secure Horizons.  They do not require the 6month weight loss.  Elaine said the approval takes 3-6 weeks

 

Happy Holidays to you and yours.

Cindy, Thanks for the post. I cannot believe that they are making you weight 4 more months. Do you have to see the psych every month then for those 4 months? Once the Psych gives you the all clear then are you all set for surgery or do you have to wait for it to be approved then? I wish you the best and I will keep my fingers crossed for you and pray for you too.

Happy Holidays.

Amy

I tried to have them turn in the paperwork for approval but they won't do it. Until all the ducks are in a row.  Did you have a psch eval?  Who did yours? I am trying to find someone for a second opinion

Yes I did have a psych eval done by Dr. Groh at Theda Care Behavioral Health in Menasha. He was very good and I really, really liked him. Is that who did yours? If not, you should call their office. If you need the number I can get it for you. If you  did got to him I would check and see if you can see someone in your insurance plan and get a second opinion from them. It never hurts to try and if the second opinion comes back that you are fine for surgery just turn in that paperwork. I understand someone being depressed, but how can they say you are too depressed. Obviously you are depressed about needing to loose weight and that have this surgery would change that. I hope you are able to find someone who will give you the all clear. Let me know if you need that number.  Amy

Dr Groh is who did my psch eval.  I am going to try to find someone for a second opion.  According to him I am in "CRISIS"  with my depression.  Actually I think it is because I answered the questions incorrectly.  He said if it was more yes than no answer yes.  So if it was ever yes I answered yes.  But when he explained it later he said the numbers were situationally driven.  So I think I made it look alot worse than it really is.

Contact your insurance company and see who they have listed as psychologists and go to one of them and see what they say. The test that Dr. Groh had me take was very long and it was very confusing.