Recent Posts

WASaBubbleButt
on 11/24/10 11:33 pm - Mexico
Topic: RE: denial from cigna?
Are you actually using a C-Pap? Meaning, were you diagnosed with mild sleep apnea not requiring treatment or was it severe enough they gave you a C-Pap to use every single night?

Previously Midwesterngirl

The band got me to goal, the sleeve will keep me there.

See  my blog for newbies: 
http://wasabubblebutt.blogspot.com/
Disappearing Me
on 11/24/10 10:59 pm - Murphysboro, IL
jhiggins5377
on 11/24/10 10:31 pm - Rittman, OH
Topic: RE: Approved!
Congratulations!!!!!
jhiggins5377
on 11/24/10 10:29 pm - Rittman, OH
Topic: RE: Aetna Approved
Thanks I will. I will find out next week what my surgery date is.
kimberly_gr
on 11/24/10 10:11 am
Topic: RE: Aetna Approved
Congratulations to you! Let us know when you have your surgery date.
Kim
5'0"
"In two decades I've lost a total of 789 pounds. I should be hanging from a charm bracelet."  Erma Bombeck
  
279
on 11/24/10 8:21 am - OR
jhiggins5377
on 11/24/10 3:50 am - Rittman, OH
Topic: Aetna Approved
I just got that call that I am appoved!!!!!!!   There is nothing better than getting the call right before Thanksgiving. I have so much to be thankful for this year!!!!

This process has been so stressful but in the end it is all worth it.

I feel amazing right now
WiseTears
on 11/24/10 2:56 am - Chicago, IL
Topic: RE: Psych Eval?

If the psychiatrist evaluating you believes that you have underlining issues( i.e. depression or an eating disorder) causing you to become obese, then they will suggest therapy before recommending surgery. In fact, all insurances required that you recieve a psychological evaluation before going under the knife in hopes that this will be the last attempt at weight loss. So, you wont neccessarily be denied but your surgery could just be postponed until you seek treatment.  

Some of the questions they will ask: years of obesity, family history, eating habits, tramatic experiences, etc. I remember specific questions about suicide, binge eating, smoking, stress, depression, expectations of weight loss surgery, etc. My psychiatric evalu was 45 minutes. The most important thing when doing this is to be transparent about any issues that you are facing in life. If you are not, it will directly affect your accountability after you have the surgery. For instances, I was diagnosed with depression and binge eating from my psych eval. Even though, they postponed me for 3 months until I sought treatment, it was the best day of my life. It gave me a reason to dig deeper to understand why I was obese and to address tramatic experiences from my childhood. I recently went back to get my psych clarence for the surgery and thanked the psychiatrist for noticing the depression and bing eating. Be TRANSPARENT & ACCOUNTABLE!

    
Kimmes
on 11/23/10 7:12 pm
Topic: RE: New Insurance
Check and double check.  Call the new health plan administrator Amerihealth and let them know the situation.

Personally I would beg...plead with your surgeon to get you scheduled for Dec.. earlier rather than later.. Explain the situation.  I am not sure if you employer has a fully insured or self insured medical plan  - if it is self insured you may have some flexibility.  Many fully insured plans (at least here in MN where I live) are starting to exclude all WLS effective Jan 1st.

If they can reschedule you based on what I would consider urgent need that would one less stress on you.  I would hate to see it excluded on your new coverage or have them require you start over.  If it is a covered procedure under your new policy and they have different requirements I would appeal having to meet new requirements and get your Dr involved.  Best wishes to you!

Had VSG on Jan 6, 2011 with Dr. Jaime Ramos-Kelly
Start weight 239.8/Su
rgery Day 217.6/goal:155/Current Weight 144.0  I made it -Goal in less than 10 months

LilySlim - Personal pictureLilySlim Weight loss tickers


    
279
on 11/23/10 8:36 am - OR
Topic: Psych Eval?

I am kind of nervous that insurance will look for ANY reason to not approve this expensive procedure, and am wondering if the psych eval is one of those ways.
Can y'all share what they asked (not specific), what types or whatever..
And anyone been denied BECAUSE of the psych eval?

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