Medica Group Policy, Can I get another policy?

salgalbp
on 1/28/09 1:27 am - Belle Plaine, MN
Hello All - just a quick overview here I went through 3 appeals and 4 deniles to get the BPD/DS in 2006 - spent 2007-2008 trying again myself and am now in the process of waiting approval for the RNY as I was at my wits end.
However, I would much prefer the BPD/DS as I feel personally it is the best surgery for me.  Medica will not approve me for the BPD/DS because their criteria is a BMI of 50 or more and I am currently at 45.9. 
My questions are these:
#1 - Has anyone here been approved for the BPD/DS with Medica with a BMI lower than 50 recently like in 2006-today.
#2 - I have a group policy through my employer and a secondary policy BCBS of MN with a claus of max lifetime $20,000.00 for any WLS (Kicker is I have to get approved from Medica first as they are my primary)  With that said the question is can I as an individual buy another policy even if I'm already covered (I think the answer is no) but thought I would check.
I'm so concerned about failing with the RNY I've seen it happen to so many people I know and on this forum - I just simply think the DS is the better choice for me personally.
Any and all info would be great.
Thanks so much!
Sally
salgalbp
on 1/28/09 1:30 am - Belle Plaine, MN

Wrong info - Medica requires a BMI of 55.  Seriouslly I would have to gain 60lbs to qualify and I can't as a good honest person do something like that.

talksoupslp
on 1/28/09 9:01 pm

Generally speaking, individual policies DO NOT cover weight loss surgery...assuming you can get them to cover you at all.

-TS



Highest Weight/Surgery Weight/Current Weight/Goal
426.4/356/216.8/165?
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