What insurance did you have when approved for DS
I have just been curious...
What insurance provider did you have when you were approved for DS?
I know that all companies and plans are different, I'm just curious as to what insurance company approved you? I currently have Cofinity and I know my plan through my work does not cover any form of bariatric surgery, however my husband will be getting Blue Cross Blue Shield of Michigan through his employer soon and I am hopeful his plan will cover it.
Thoughts?
it was fairly quick. i think 2wks max they had a decision. they denied me first for not doing the 3 month diet but i had done 5 months worth and called them back. the rep was super helpful and said i don't' see why they are trying to deny you, you meet all the qualifications. basically the nurses/case managers tried to deny me for no reason. i called their BS and got an approval the very next day.
United Healthcare
C-Girl
Starting Stats: Ht: 5' 0" HW: 242 ~ SW: 229.9 ~ CW: 117 ~ Goal: 124.9 ("normal" BMI)
% EWL @ 03 months: 36% % EWL @ 09 months: 80%
% EWL @ 06 months: 63% % EWL @ 12 months + 2 weeks: 100%
BCBS TN (a Medicare Advantage policy) which approved me, no questions. And as long as I used a surgeon on their list at a COE, they paid 100%.
We also had United Healthcare (primary/only for dh, secondary for me). UHC approved his surgery and paid 100% of his, did not approve mine. (I failed the five years of continuous obesity the policy required).
Liz
Duodenal Switch (Lap) 01-24-11 | Surgeon: Stephen Boyce | High weight: 250 in 2002 | Surgery weight: 203 | Lowest weight: 121 | Current weight: 135 | Goal weight: 135
Aetna.
Quick note, sometimes it depends on the size of the company you work for. Insurance plans for small groups usually exclude coverage because of the cost of the procedure vs how much they can collect in premium on a small case with only a few members. Of course, national employer groups get to decide what they do or don't want to cover because they self fund the plan, so they can exclude or include at their own whim. Bottom line is to get it covered you need to work somewhere with at least 300 employees.
Thank you all for your responses - they are greatly appreciated!
My husband works for a smaller company (roughly 30-40 employees) however they are part of the Local United Auto Workers Union here in Detroit and from what his co-workers have told him, they have excellent insurance. But whether or not they cover bariatric surgery is still to be seen. I will keep my fingers crossed!
Thanks again!
- Kari :)