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I'm getting rid of my band and switching to the sleeve. I'm using Tampa General Hospital because they accept Staywell.
I looked at my Florida BCBS policy and it has an exclusion for bariatric surgery. I went to an information session last night at a surgeon who I am researching, and his group provides details about which insurance companies they can work with, and what is required to submit for approval.
Maybe start there... find a surgeon, then find out what insurance companies they have had luck with. You wont find anything 100%, typically you have a dollar amount you have to reach before they cover stuff, such as $2500, then they cover 80%.
Look in to it some.
So I've recently been looking into getting gastric bypass surgery. My first concern is insurance. Calling around to the major insurance companies I keep getting shot down with, "Oh no ma'am. we don't cover ANY type of bariatric surgeries." I was wondering if anyone knew of any companies that would, under certain policies, cover gastric bypass surgery 100%?
call them and ask tobe sent a copy. If they give you the run around,tell them you KNOW,that by law,they. hAVE to provide you with a copy if you ask for it.
All of this paperwork is confusing me. I just got something from Atena re: my living will and the Power of Attorney. They are saying that the person with POA can't be in my living will. That, to me, is insane. My Fiancee is the one who is responsible for my POA if my sister isn't avail. But guess what, the POA can't be a blood relative either.
I don't know what to do. There are a total of 2 people who I literally would trust with my life and my belongings and they can't be my POA and/or be on my Living Will.
What am I supposed to do?
on 1/24/16 5:35 pm
I'm working on getting a copy of the actual policy right now. Every time I go to the website to look up my benefits, it says they aren't available. :(
Im 5 ft 6 and weigh 260. I think my bmi is around 40-42 right now. I have pcos, a testosterone dificiency, high cholesterol, and hypothyroidism.
My concern is that I was able to drop over 100 pounds in 2012, I went from 317 pounds to 195 in a little over a year with a strict diet and exercise routine but then my hormone issues kicked in and I've ballooned up over the last 2 years. I still work out and eat healthy. I'm on so many meds it's ridiculous. The weight isn't budging.
Will the the fact that I lost weight then gained it back hurt me?
not necessarily. It depends on exactly what your insurance requirement specifies. Some want proof of loss with no gain and some only want proof that you tried and weren't successful. Losing it and not keeping it off is sort of a gray area. Have you read your policy for yourself to see what it says?
PCOS may be the only comorbidities you have but your BMI should qualify you.
on 1/24/16 2:23 pm
Im 5 ft 6 and weigh 260. I think my bmi is around 40-42 right now. I have pcos, a testosterone dificiency, high cholesterol, and hypothyroidism.
My concern is that I was able to drop over 100 pounds in 2012, I went from 317 pounds to 195 in a little over a year with a strict diet and exercise routine but then my hormone issues kicked in and I've ballooned up over the last 2 years. I still work out and eat healthy. I'm on so many meds it's ridiculous. The weight isn't budging.
Will the the fact that I lost weight then gained it back hurt me?
Just wondering how many of you have had your surgery approved through MVP insurance. They are based in New York. I live in Florida and have the EPO plan. Are they more likely to deny or approve WLS?
they told me I need to have proof that my weight has been an issue for 2 years, documented proof that I've tried a medically monitored diet plan for at least 6 months, and have a BMI of 40+ (35+ with weight related health issue).
I've had weight issues my whole life. Not sure where to start with documenting this.
for documentation,you would need doctors visits,including a weight,on those visits for 2 years. You also need proof of 6 months of medically ,doctor supervised weight loss.
if you have seen a doctor recently,or in the past,you should know if you have diabetes,sleep apnea,high blood pressure etc that are co morbidities. What is your current BMI?
Hockeymom87 · 0 replies · 611 views
