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Got my plan documents on Saturday and it has a special section about WLS, which is 100% covered under my plan as long as I haven't had a previous WLS in the last two years. Sending it off for approval this week!
Sending it off this week and am super nervous! It is brand new insurance, and my policy specifically states WLS is covered, I'm just nervous that something will go wrong!! I'll feel much better after I have an approval! Real nail-biting going on over here! 
Yes Maggie I turned in my 6MSD visits but I need to redo my Pshy evaluation which stinks so I still have to wait
As long as you have 6 months that aren't over two years old showing your weight and discussion of diet plan you should be good. Does your ins. require a weight loss? Mine did but didn't tell me how much. The dietician at the docs office told me 12-20lbs. I was 5'2 and 250. I'm sure those numbers are based on a certain percent.
Maggie May
My primary insurance (UHC) and Medicaid as secondary both had the same requirement of BMI of 40 and 6 months medically supervised weight loss program. This means you must have a record of a medically supervised diet for 6 months which means a record of being weighed every month for 6 months by a medical professional. In those 6 months, you must lose at least 10% of your body weight in order to get approved. If losing 10% means you fall below the required BMI for surgery, that is ok. They need to see you are motivated and willing to change your life. I contacted my insurance company in December. I started my program with the dietician in January at 250. I weighed 224 when the surgeon submitted to insurance and I was approved in 7 days. I was 217 on the day of surgery. 2 1/2 weeks post op I am 200. I was on the edge when they submitted to insurance too. I was told by my case manager with the insurance company that would not be a problem.
Maggie May
If Medicaid covers WLS in your state, they will pick up the out of pocket as long as you have met their pre-surgery requirements. For my state you need a BMI of over 40 w/comorbidity, a 6-month medically supervised weight loss program, psych eval, and referral from your doctor. My primary insurance only covers the hospital, not the surgeon's fees. Medicaid picked up what the primary didn't cover.
Maggie May
Our ObesityHelp Events are an amazing experience for you! With less than ONE MONTH go to, please join us for our 2013 ObesityHelp Conference in Anaheim, California on October 4th and October 5th for the time of your life.
Straight from our members that have attended an ObesityHelp Event.....
Every surgeon is different. It's best to give the office a call and they'll let you know. Goodluck!
Never accept NO for an answer. 
Hockeymom87 · 0 replies · 724 views
