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I called my insurance and I'm waiting for them to send me the handbook where hopefully I can get specific info regarding coverage and bariatric surgery.
On the rep's end she didn't see a specific amount of time needed (I was told six months before.) I was then put on hold and she spoke to someone in the authorization department and in short I was told it doesn't hurt to have the surgeons office put the claim in early and at least I will know what else might be needed. I found this interesting. I'm a revision or a completion to the DS.
Anyone who need or needed to do a six month consecutive visit with your doctor, did you ever see it in writing from your insurance?
Thanks for responding.
I have bcbs of mi and it covers wls. I do not have to do a 6 month supervised diet because my bmi is above 50, and my insurance waives the process for anything above 50. I have begun the process towards getting a duodenal switch. My surgeons office told me the total process for me to complete all requirements for my insurance will only take 2-3 months. I have only a few more things to do before I submit my request for approval for the surgery. Of course, this has made me beyond thrilled. I guess my question is about the insurance approval process. Anyone have bcbs and cover all requirements and still get denied? Or how long did it take for you to get your approval/denial from bcbs from the day you submitted your paperwork?
Just curious if you had heard back from your ins? I wondered, does your bariatric surgeon send in your paperwork or do you?
Hi. I'm new to the site. I am hoping to have WLS, leaning towards the sleeve if I can. If not, I will do bypass.
I called my insurance (highmark BCBS) and asked if they cover WLS and what the requirements are. I was told that it's not approved. However, if I can get the proper diagnosis and procedure code, they MAY cover it.
So my question is, what do I need to get from my Dr to convince them I need this surgery? I have no co-morbities but do have quite a few things related to my weight and my BMI is 51.
Any help is greatly appreciated.
I was in the same boat. My group plan was with UHC and WLS was excluded and the kept telling me to appeal. I did that and finally found out that my employer did not purchase the rider. My doctor and I sent my employer letters explaining the need for this. They looked into it and later refused because the cost was to high. Doing my research I found out that the WLS ridder would have cost $1.04 per month to each employee. That's it $1.04. I got with a good private health insurance agent and she helped me find a private policy that covered WLS. I left my group went to a private plan. My monthly premium is $30 more a month than my group. My WLS was approved in less than 24 hours.
You still have options. Don't give up.
Has anyone been able to get approval for surgery through Aetna International for gastric bypass ?
Hi,
Can anyone help me please? I wanted to undergo lap band surgery, I weight 191 lbs and have a severe sleep apnea but when I sign up for online request more information about lap band in a one hospital in Wisconsin..I received a call a woman from that hospital explaining things to me and told me that I'm not qualified cause my insurance only covered a bmi above 40...I don't really know what to do, I'm very frustrated can someone please help me? It sound to me that she don't coordinate much more to my insurance please help?
Thanks,
fhel
My employer would not add the ridder to our group plan ($1.04 per month cost to each employee on the plan)
i moved to a private Presbyterian plan on January 1. On Friday January 10 I sent insurance card to barriatric office the following Monday I had my approval before noon.
a rider is a type of add on policy to your main policy. Most individual policies don't cover Wls because the person would might just. Cancel the policy after the insurance paid for the surgery and they wouldn't get their money up from in premiums.
The very few policies I have heard of that might cover i,the monthly payments are very expensive.
gl
Hockeymom87 · 0 replies · 857 views
