Confused about insurance qualificiations

kayemf72
on 8/28/07 10:21 am, edited 8/28/07 10:23 am - Henderson, KY
My husband job has Aetna & BCBS of ill. aetna is 4 doctor visit and BCBS is 4 hospital services only. Will I have to be approved from both of them? Also they both have the same requirements: bmi exceed 40, 6mth supervised diet & exercise with physician and dietican. pysch eval, & behavioral class & presence of severe obesity for at least 5 years. I am going to a bariatric center ,which this is my 4th month with them. I have already had all test and classes done. My insurance showsthat i have a coinsurance of $1500and my deductioble is $100  and i have met those amounts.  So my question is has anyone else been thru this w/ their ins. and after doing this will my insurance approve me? 
Full of Life
on 8/28/07 11:09 am - Broken Arrow, OK
It's great that you know what your insurance(s) require!!! It looks like you're on track to submit to them soon!!! Yes, you generally need approval from both of them.  I had just Aetna and they seem to be pretty good about approving those who jump through the hoops. I did have to appeal mine, but I didn't have to "do" anything else, just submitted more thorough information to them.  Best of wishes to you in your wls journey!!  HUGS

Laurie
I can do all things through CHRIST who strengthens me

 

RNY 5-19-05      
hernia repair/tt 4-10-06
BW: 262 lbs     GW: 140 lbs     CW: 126 lbs

5 Day Pouch Test Graduate!!! I lost 5 pounds and feel GREAT

Kerri G.
on 8/29/07 12:53 am - Overland Park, KS
Also, just try to remember that you will probably need to meet ded & out of pocket max  again if it's done after the 1st of the year.  Most insurances won't carry over ded & coinsurance max's unless they are applied in the last 3 months of the year.
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