Is Insurance CS Pulling My Leg?m
Thanks you all for your replies. I have scheduled my first appointment. I called the insurance company to make sure I have a good grasp on what I need. Below I'm pasting what it says in my benefits packet.
"Documentation of failure to lower the body mass index within the last 12 months through a medically supervised program of diet and exercise of at least 6 months duration."
Personally I would expect GEHA to tell me I would have to start a six month process with a doctor, but I'm just confused now. Obviously I would love to have my surgery earlier especially since I have scheduled leave coming up. Would it be obnoxious of me to ask the bariatric office to send in my request and see if it is approved and if not then we'll do the six month program? Also, if I have to do the six months, could I switch to BCBS and expect them to approve it in January? I'm obviously going to ask the bariatric office, but I was wondering if y'all have seen this scenero.
on 5/23/16 8:55 am
If you submit things now and get denied, it may make it more difficult for approval in the future.
Can you contact customer service again and see if you can get the details on "non-consecutive weight loss attempts" in writing?
Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!
There are also a bunch of other pre-op activites that you will likely need to do, so even if you get denied, or if the surg will not submit yet, your delay will probably be less than 6 months.
Sharon
You've got it started! See what your surgeon says. (I had a lot of other things to do before surg go scheduled - they will tell you at your appointment.) Some is req by ins co, some is required by your dr to make sure you are healthy for surgery.
Good luck.
Sharon
I live in NY and had Oxford/United healthcare. I only had to give 6 months of weights and it was OK even though one was missing. I was able to go back to primary and have her give me a letter with several weights from visits, I had had a test in the hospital that year, so they used that, then they used 2 times I went to the Bariatric surgeon.
Cynthia 5'11" RNY 7/23/2014
Goal reached 17 months. 220lb Weight Loss
Plastic Surgery Dr. Joseph Michaels - LBL and Hernia Repair 2/29/16, Arm Lift, BL, 5/2/16, Leg Lift 7/25/16
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