Does anyone have Caresource Insurance(Ohio) ?
Hello, have any of you had bariatric surgery through Caresource insurance ? Have any of you applied for bariatric surgery through Caresource (Ohio) ? If yes the either, can you please tell me if they approved or denied your claim, did you have to appeal, and what your BMI index, weight, and co-morbid conditons were at the time of approval/denial. I really would appreciate any feedback. I am new to this website. I am in the begining of the process of Bariatric surgery and currently in my 3rd month of my 9 month supervised diet.
If you have any tips for me, I would love to hear them as well.
Thank you all, and have a blessed day!
If you have any tips for me, I would love to hear them as well.
Thank you all, and have a blessed day!
Hello,
I am also in the beginning stages but I have Molina of Ohio which is another managed plan through Medicaid. While I can't comment about authorizations yet, I can tell you that Molina only requires a 6 month weight loss attempt or wait with the surgeon. Since the time has come in the year to either choose another plan or keep the one you have -you may think about switching since that will knock three months off your wait!!
Luckily my husbands new insurance kicks in October 1st and his insurance does not require a wait. So my surgeon says we can schedule surgery by the end of the year most likely since I am completing everything needed this month.
Good luck!!
I am also in the beginning stages but I have Molina of Ohio which is another managed plan through Medicaid. While I can't comment about authorizations yet, I can tell you that Molina only requires a 6 month weight loss attempt or wait with the surgeon. Since the time has come in the year to either choose another plan or keep the one you have -you may think about switching since that will knock three months off your wait!!
Luckily my husbands new insurance kicks in October 1st and his insurance does not require a wait. So my surgeon says we can schedule surgery by the end of the year most likely since I am completing everything needed this month.
Good luck!!
Hello . My name is Angel .. I had My Rny On Feb 21st 2012.. I Have caresource I live in wadsworth ohio.. I got caresource to cover my surgery but It was not Easy I did the 9 month diet in 2010 when I first started the process I lost weight did everything they askd me too only to get denied.. I appealed it twice and It still got denied their reason for denial was that it wasnt medically nessacary I was more than 100 lbs overweight had very high cholesterol but wasnt on meds for it also had pcos and high blood pressure and asthma digenerative disc disease.. That being said I Got depressed, Ended up pregnant and Gained all the weight and then some that I lost during the nine month diet..SO At 330 lbs I started to do more research and I Got all my medical history my self and wrote a letter to my insurance stating why It was ness. for me to have surgurey at the time my bmi was 51.2 . I printed out the caresource guidlines which stated if you have a Bmi over 51. Then you dont have to have any Existing co morbities. I sent all that in and they still denied me .. I was furious So I called them and tore em a new butt hole demanding to know their stupid reason this time.. Their reason I failed to do A nine month diet .. Not true I did do the nine month diet but they were trying to pull one over on me so I called my surgeon and they got it all straightend out! and wham 3 days later I had a surgurey date. If you get denied appeal and appeal again take them to court do your research you need to prove to them that paying for your surgurey is going to save them money in the long run list any medications they pay for surgurys or other problems that has to do with weight. hope this helps if you need any other help message me!
Hi Angle, my.name is maria, I have caresource I am going to see the doctor in hope of get to g my surgery, what can i do to I increaso my chances of them paying for this. (I do more than I 100 plus to lose,sleep.apnea, I have blood pursuers, when walk the pain is horbblle,I) any advise you can have with me. Thank you in advance!#
I have Wellcare of Ohio and it was easy.6 months supervised weight but I only did 3 because my doctor submitted weight checks from my sick visits I do know a woman who had caresource and had no problems getting approved,neither of us had to appeal.Hopefully in 6 months I can get my plastics as easily
HW 289 SW 242
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