Badgercare

Hello, I am wondering if anyone knows which weight loss surgeries ARE covered by BadgerCare and which ones are not, if any. I am going for the DS and I don't want to get my hopes all up and then find out that it's not covered. Thanks for any info!

I have BadgerCare with United Health Care as my HMO. I called and was told that the lap band was not covered, but gastric bypass (RNY) was. Call the number on the back of your card and ask. If you have a HMO call them instead and ask what is covered under your policy. Each policy can be different. Also, keep track of when you called and who you talked to for your records. Good luck.

I have BadgerCare and CompCare as my HMO.. so who would I call? Both companies? I know RNY and Lap Band are covered but neither of them are my choice. Thanks for your reply :-)

Call CompCare, if it is like my HMO all prior authorizations and approvals will go through them. I called BadgerCare and they say that weight loss surgery is a covered benefit if medically necessary, but that the approval goes through your HMO. Good luck. Also ask them what are the requirements for prior authorization. I found out I have to have 6 months of visits with a dietician for prior approval. good luck. Julie

One suggestion I have for anyone considering any weight loss surgery or plastic surgery on BadgerCare is this:  if you have an HMO, read your guidelines carefully.  If you have a choice of providers, compare them carefully.  There may be differences you aren't aware of now that could make a huge difference later. For example: I chose an HMO (Atrium) a while back.  It changed to CompCare.  I figured it was probably similar to Atrium (mistake #1), so I didn't compare it to my other choice, Group Health (mistake #2).  A couple of years went by before I found out accidently I could have been seeing my previous doctor 6 months earlier had I changed (mistake #3).  I have a lot more choices with Group Health than I had with CompCare and I had no idea because I hadn't bothered to check.  I'm not saying it *will* make a difference for you or something will be approved that wouldn't otherwise.  I'm just saying it's worthwhile to take a look. You can change once a year and it take one month for the change to take effect.

Thanks everyone for helping me out. I am absolutely clueless when it comes to insurance, and you all have made it so much easier to understand.

Hi,  I have Badgercare with Compcare as my HMO too.  I do know RNY is covered, but don't know about anything else.  My info. was sent in this past Tues for approval decision.  When I talked to lady at Compcare she told me it takes about 7-10 days for a decision, but sometimes faster.  I am anxiously waiting.  If you have any more questions pm me, we can share our experiences with Compcare.