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Recent Posts

noftessa0401
on 10/8/13 7:18 am - San Diego, CA
RNY on 12/27/12
Topic: RE: Longshot Question about insurance

I'm sorry no one replied to this.  It really depends on each insurance company.  For example, Aetna requires that the 6-month supervised happen within 2 years prior to the surgery.  They have a 3-month option that they require happen within the 6 months prior to the surgery.  It appears that BCBS's medical policy bulletin is silent as to the timing, so, you might make it.

HW: 274 | SW: 232 | CW: 137 | Goal: 145 (ticker includes a 42 pound loss pre-op) | Height: 5'4"

M1: -24 (205) | M2: -14 (191) | M3: -11 (180) | M4: -7 (173) | M5: -7 (166) | M6: -8 (158) | M7: -11 (147) | M8: -2 (145) | M9: -3 (142) | M10: -2 (140) | M11: -4 (136) | M12: -2 (134) | M13: -0 (134) | M14: -3 (131) | M15: +4 (135) | M16: +2 (137)

Member Services
on 10/8/13 3:21 am - Irvine, CA
Topic: Non-Scale Victories (NSVs) for pre-ops, post-ops and non-ops

We LOVE NSVs.  Check out this video on NSVs that contains some of our fellow OH members and speakers from the 2013 ObesityHelp Conference, courtesy of OH Member, Beth Sheldon-Badore.  Inspiration for all of us as we live our healthy lifestyles every day. 

What are some of YOUR NSVs?

DeeDeeLynne60
on 10/7/13 10:03 am - Massillon, OH
Topic: Medical Mutual Coverage
Anyone out there have experience with Medical Mutual paying for a revision/wls?? My insurance (medical Mutual Plus) said they do not cover weight loss surgery of any kind! But what if I am having secondary problems from my original surgery? Anyone know?? Thanks!
DeeDeeLynne60
on 10/7/13 9:56 am - Massillon, OH
Topic: Medical Mutual Coverage
Anyone out there have experience with Medical Mutual paying for a revision/wls?? My insurance (medical Mutual Plus) said they do not cover weight loss surgery of any kind! But what if I am having secondary problems from my original surgery? Anyone know?? Thanks!
KristenRB82
on 10/6/13 1:29 pm
Topic: RE: Five year documented weight history question
I'm right there with you on that one. I only have two of the five years documented. My surgeons office coordinator doesn't seem like she has a lot of hope. At this point I am still pressing onward with all my appointments and pre-op tests. and if it means a medical loan, then so be it.

I'd be broke with bills than live another year like this.

Lots of luck to you!
(deactivated member)
on 10/6/13 11:53 am
Topic: RE: Surgery next year after Obamacare starts...

I will have a revision in February, too.I wondered about this as well, but I will still have my private insurance, so I think I will be ok. I need to get everything and anything done before things change.

mollymcb
on 10/6/13 3:26 am - TX
Topic: RE: Five year documented weight history question
I'm not sure which insurance you have but don't give up hope my insurance really took a statement from me and my surgeons office of what diets I had been on in the past 5 years.. I had a horrible time when I first started trying to get approval due to me having 2 insurance policies at that time it took me few months to figure out what needed to be done and now I'm approved with a December date... Have faith
melissabeth
on 10/5/13 10:52 am
Topic: Five year documented weight history question

Hello, this is my very first post.. I have a question for anyone that will listen. I've been considering gastric bypass for a long time and I finally have a new job with insurance and I've got to a great place in my life and I felt like now is the time. I went to a seminar and it was incredible, positive and informative. I happily started filling out my packet the next day and started to try to line up appointments.

Then I got the call about my insurance. I had no idea about the 5 year documented weight history that would be required. That is the only thing holding me back from insurance helping me with the surgery. I lost my job a few years ago which meant I lost my insurance.. when I got sick? I toughed it out and never went to a doctor. I have no records of being weighed, not from a doctor, walk in clinic, ER, etc. Literally, a $20,000 mistake. I was quoted $4000 with insurance after meeting requirements. Self pay would be $24,000.

I am absolutely crushed. I've been crying for days. I'm keeping the appointment I have next Friday with my MD, I am going to ask her if she will send a letter of Medical Necessity. I feel in the back of my mind that it won't work and they won't approve it.

Have any of you had this happen? Or had a letter of Medical Necessity work for you?

Any advice would be greatly appreciated. Thank you so much.

uglymouse
on 10/4/13 10:47 am - newnan, GA
Topic: RE: BCBS of AL PPO... Consfusing to find PPO-approved Bariatician near ATL
I know my doctor is at Piedmont Hospital in .Atlanta. There were people in my NUT class that had BCBS. I have United Healthcare.
rivieramaya05
on 10/4/13 7:07 am - TX
VSG on 12/16/13
Topic: Longshot Question about insurance

I realize theres a good possibility no one will know the answer but I have BCBS. My insurance requirements  with them for a revision include a psych consult, nutritionist and 3 months of a supervised diet. I have a "in" with my surgeon (he works with my husband) and am wanting to have the surgery done before the end of the year because I've met my deductible. The kicker is the 3 month diet. So here is my question. Last year I visited a doctor who tested me for everything because I was unable to lose weight with my band so I was hoping it was a chemical issue. We also did a supervised diet for 6 months. What are the chances of the insurance company accepting that even though it's a year ago?

The bariatric coordinator told me to go ahead and get the records and she'd try to submit them to see.









 

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