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You also have to remember the surgery is not MAGIC---you will still have to make ALL the changes we 'hefty' people don't want to do...being on a diet will basically be a way of life after the surgery. but yes I think all the hoops they make you jump are a drop in the bucket in the "Big Picture". If you want it, just do it...do whatever they ask you to do...My insurance made me do the whole diet, psych evaluation, support group meetings, nutritional meetings..etc..etc...then they tell me "too bad, so sad...we're not covering the procedure!" WHAT?!?!?! So believe me I'm more pissed than you are...but you know what...I'm going to look into getting it done in Mexico...I hear it's not bad at all...so please keep up the good fight and get it done--if it's what you truly want, do it...anything worth having takes work and effort. I wish you all the luck!
How did you get CIGNA to even review your paperwork? I finished all the "steps' to a tee...and when the hospital submitted the paperwork, they denied th case saying CIGNA doesn't cover WLS?? That the person the Hosp initially spoke to and said they did was wrong---so after more than $500 in tests and fees and co-pays...I'm nowhere near getting this done...I almost cried...Just curious I suppose.
I agree, the secondary is not going to pay before the primary pays. You will need to meet the requirements of both insurances and the primary will be billed first and the secondary second. I am also double covered and that is how it works. My visits are covered by my primary first and then by my husband's insurance (secondary).
good luck!
Nan
Nan
HW 300 / SW 280 / CW 138 / GW 140
Hit Goal 4/2/2010
on 5/18/13 4:48 am
Self pay in Mexico is cheaper than going through your insurance. :( However, IF you do your research it is very safe. But as i told you in the revision forum, different states vary in laws of how they can code. Some can do a revision and the ins only pays for the band removal and some states are not permitted to change coding. Sounds like your state is one that is unable to change coding.
on 5/16/13 6:11 am
I figured 
Thanks so much for your reply.
Any one know if temporary disability covers it?
No, they don't. But COBRA would. It's almost cheaper to go to MX than to buy COBRA. :o(
Most self pays do go to Mexico, i did. Once for my band (band was a HUGE mistake) and once for a revision to a sleeve 5 years ago.
I would seriously think twice about RNY. Your job loss is the very reason I suggest this. What if your next job does not cover WLS? Even IF you self paid anywhere for RNY and your ins does not cover WLS, they don't have to pay for your labs.
Sleeves lose just as much weight as RNY with a fraction of the risks and complications and NO aftercare. Labs are your annual CBC/Chem Panel with an added B12 on top of it. It's the safest surgery type long term.
He has had other patients do their supervised diet with him so I think he knows, but I will let him know just to be sure :) I will start a log today. I am still early enough out that I believe I can recall everything :) Thank you!
Waiting for surgery
My Thought on WLS: I can restrict what I eat, or I can do nothing and let what I eat restrict me!!
"If you always do what you always did, you'll always get what you always got"
I've been on a constant diet for the last two decades. I've lost a total of 789 pounds. By all accounts, I should be hanging from a charm bracelet. ~Erma Bombeck
on 5/14/13 6:10 pm
Just in case I have started a 6 month supervised diet with my PCP I also have a membership to anytime fitness and go at least 3x a week. but just recently started... how do I go about getting that proof? Do I have to tell them what I need it for? I kinda feel like its none of their business, you know?
Have the gym stamp something or sign it. Keep a running log, tell them you have a bet with a friend on who will go to the gym the most. Tell them it is for tax purposes, it doesn't matter.
Make sure your doctor DOCUMENTS monthly that s/he weighed you AND you discussed diet and exercise.
Just in case I have started a 6 month supervised diet with my PCP I also have a membership to anytime fitness and go at least 3x a week. but just recently started... how do I go about getting that proof? Do I have to tell them what I need it for? I kinda feel like its none of their business, you know?
Waiting for surgery
My Thought on WLS: I can restrict what I eat, or I can do nothing and let what I eat restrict me!!
"If you always do what you always did, you'll always get what you always got"
I've been on a constant diet for the last two decades. I've lost a total of 789 pounds. By all accounts, I should be hanging from a charm bracelet. ~Erma Bombeck
I figured Thanks so much for your reply.
Any one know if temporary disability covers it?
Hockeymom87 · 0 replies · 838 views
