Healthy Indiana Plan

Hello, everyone, I'm new here and have scanned through posts but can't find the answer to my question...

I have the Healthy Indiana Plan and am just starting the process to see if I qualify for weight loss surgery.  I just saw my doctor yesterday and am waiting on the call for an appointment from the place my doctor referred me to...

My question is...does anyone know if HIP requires that you have co-morbidities to qualify for the surgery?  I don't really have any...other than depression, which I feel is greatly caused by my frustration with being overweight, but I doubt if that will count.  I can't get MDWise customer service to give me an answer, they just keep saying ask my doctor, but she didn't know, and I don't want to waste my time with this referral if I'm not going to qualify.

Most plans only require co-morbidities if your BMI is lower than 40.

Every insurance plan is different, so nobody here can give you a concrete answer.

Do you have access to a benefit book? You can usually get one online, or have customer service send you one in the mail. That should have a list of requirements and exclusions, including requirements for BMI/comorbidity.

The benefit book doesn't have any information on it, and when I contacted customer service they said "ask my doctor" and she didn't know either, lol.  I do know that most people aren't going to be able to answer me, I'm just hoping that someone *****ads my post will know from their own experience, maybe from having gotten the surgery while on HIP.  :) 

Your insurance person was lying or stupid because they are the only ones that can tell you what your coverage is. If there is nothing in the benefit book tho they may well not cover it. So you need to get an answer preferably in writing from your insurance company before you go too far or you may end up having to pay for some of the things you do.

All it says in the member handbook is that it is covered.  I was hoping to find out if they require co-morbidities, or if it is like other HIP carriers.  Anthem HIP requires co-morbidities only if your BMI is under 40 (which I found on their website, in their member handbook).  I don't understand why no one with MDWise can tell me anything.  I've sent them another message, and told them as much, clarifying that I was able to find the information for other insurance companies but unable to find it for my coverage, even when I was logged in and reading about my personal coverage.  I told them that I find it hard to believe that there is absolutely no information that will give me an idea of whether or not I will be able to be approved, and I am trying to avoid a wasted 2 hour drive to the doctor if I don't have a chance of getting approved.  It's just been very frustrating.

That is frustrating but look below and Brad found everything you need so you can print it out!!! Go Brad!

Here ya go

http://provider.indianamedicaid.com/ihcp/Bulletins/BT201420. pdf

Thank you!  That helped relieve some of my frustration, and even gave me a little hope about the wait time, because according to that, if you've lost weight under the guidance of a doctor, and then gained it back, you don't have to do the 6 month wait, and I did that.  I lost 70 pounds and then gained it back a year ago.  Even if I have to wait, it looks like I'll qualify, so thanks again.  :) 

You are most welcome. Glad I could help.