Hello, Lady!!

I am glad someone reached out.  I feel like I am in uncharted waters.  However, I do have a question or two for you.

How do I even get in a see a Primary?  Do I have to chose that ahead of time?

What about Duke?  I should have done this years ago, but I was TOO scared and now I am regretting it as life takes you where it wants you to go.  :)

I look forward to sharing info with you, but I sorta had given up, but I now have renewed spirit.

Please let me know what you find out and I will do the same.

A

Hi,

I have NC Medicaid too. I talked to my PCP last night. Medicaid covers the surgery, but you are responsible for paying for the pre-op appointments such as tests and the psych evaluation. However, if you go to a practitioner that accepts Medicaid, then I'm assuming you'd pay whatever your normal co-pay is. I'm not 100% sure of this. I'm trying to find answers too. When I find out, I'll let you know. I am trying to decide between 2 hospitals--Wake Forest University Baptist Medical Center in Winston-Salem or Catawba Valley Medical Center in Hickory which is closer for me. For Medicaid patients wanting to have the surgery at Baptist, I was told there was some kind of an 18-month waiting list just to get into the program, which is another reason I'm considering the hospital in Hickory. 

Good luck to you, and like I said I'll let you know what I find out.

Sorry to have taken so long to reply! 

I did get my approval.  I followed every guideline to the letter and while it took them until the 11th hour (the day before surgery) to approve, I was in fact approved. 

Aetna's hesitation came from a mix-up in the submission;  my doctor's office had submitted with some incorrect dates and it looked like I hadn't done my full 4 months of pre-work.  When this was corrected, my doctor submitted an appeal to expedite approval so I could keep my surgery date.  

Did you find out why you were denied?  Do you seem to meet all the criteria (BMI, medically supervised diet, etc.)?  

Keep up the fight.  If WLS is the right decision for you, don't give up.  It has completely changed my life and I hope you'll find a way to get there.  

Best

Christine

Hi! This is my first time on here..... I have gone through my pre-ops, did my medically monitored diets, I basically have everything in order. I just received the letter of approval for my surgery from my insurance, but it is for the wrong procedure. It was sent in for the sleeve, when I had talked to my surgeon about the bypass. I spoke to the office today and was informed that they cannot simply request a change, they will have to resubmit all of my information for my insurance to evaluate again. So I wanted to see if anyone had any experience like this, or any advice. I know it would be "easier" if I just accepted what I was approved for, but my surgeon highly recommended the bypass for me. And I have done a lot of reading and I agree it seems it would be optimal for me. There were a couple hiccups with my insurance initially because they couldn't find my psych eval, but once they had everything they approved me quickly. Which I am hoping happens again. My hope is of course that they will resubmitted and approve the correct procedure quickly. My fear is that it will cause confusion or complications because of the two different submissions. Any words of advice or experience would be greatly appreciated. Thank you so much, in advance.

Hi Christine,

I take it from your weight tracker that you must have gotten approved from Aetna. I just found out today from Aetna that I have been denied and that it's not covered. Was your WLS covered under your plan and if not what did you do to get approval?

Thanks,

Chris(cc583)