Commonwealth Care...BMC Healthnet....Masshealth Anyone?
Do any of you have Commonwealth Care...BMC Healthnet? I do, and I'm wondering if that means we need to see surgeons specifically at BMC. I mean, I'd assume so and that's fine because I've picked mine already.
That said I haven't found ONE person yet who has BMC Healthnet or even Commonwealth Care or Masshealth that's had it done. So if you have...please reply to this thread. I really like to pick your brain a little because lets be honest, the website is pretty hard to navigate. I did however find this
info which seems very helpful.
But I want to hear some real info from you guys. Anyone?
Who did you have?
What were your administrative fees?
How long to get approved?
How long to get a surgery date?
Etc.
That said I haven't found ONE person yet who has BMC Healthnet or even Commonwealth Care or Masshealth that's had it done. So if you have...please reply to this thread. I really like to pick your brain a little because lets be honest, the website is pretty hard to navigate. I did however find this
info which seems very helpful.
But I want to hear some real info from you guys. Anyone?
Who did you have?
What were your administrative fees?
How long to get approved?
How long to get a surgery date?
Etc.
Starting Weight/ Surgery Weight
255 237
I have Masshealth / Neighborhood health plan, I went to Dr Kruger in Wareham, I went to the listing of surgeons and see who took my insurance then went from there.
I had to attend an informational seminar first then they called me for first appt. then went through the nutrition and pysch visits now i have the four classes I have to take and thats all I have had to pay for which is 500. for the classes..
any other questions I can answer for you feel free to email me..
Mary
From what the woman said when I called NHP to see if they allow the surgery she said unless it is a medical neccesity they will not let it go through. But if you have comorbities and a slight history of problems then they will allow it, but today when I was at the doctors the nurse said that if you loose weight then gain it back sometimes they will deny you...I have a history from the last four years showing my health issues I have had so i dont feel I will have a problem getting approved. Also my bmi was 44.. so that helped my situation.
I have to finish my classes that my surgeon requires you to go to before they will get it to insurance for approval.. Most of the doctors know how to word it so it goes through in most cases.
If it gets denied you fight back!! if you have gone that far dont give up! I know of a girl at work that they denied her three times and then they finally let it go through..only because she did not have a history of problems. thats why denied... all depends on the insurance and their mood of the day lmao...
Have you chosen a surgeon? is your bmi high..??
I have to finish my classes that my surgeon requires you to go to before they will get it to insurance for approval.. Most of the doctors know how to word it so it goes through in most cases.
If it gets denied you fight back!! if you have gone that far dont give up! I know of a girl at work that they denied her three times and then they finally let it go through..only because she did not have a history of problems. thats why denied... all depends on the insurance and their mood of the day lmao...
Have you chosen a surgeon? is your bmi high..??
I have BMC Healthnet which is part of commonwealth care, like your insurance is. But I had to choose someone from BMC. That wasn't hard though, I was already looking at Dr. Hess as a potential surgeon and that is who I am going with. I have a consult on Jan. 29th.
My BMI is not high. It was 39.9 when I started this process and is around 37 now. But I have many comorbidities such as high cholesterol, spinal issues, arthritis of the lumbar spine and right hip, as well as some other issues. So I think that may qualify me but am unsure. I'm in chronic pain due to the back issues I have. I have arthritis now due to an accident in 2003 that resulted in back fracture. This extra weight sure doesn't help. Ready to be active again, I was a gym rat and a damn good soccer player. Weighed in at 155lbs when the accident occured and now am 247.
My BMI is not high. It was 39.9 when I started this process and is around 37 now. But I have many comorbidities such as high cholesterol, spinal issues, arthritis of the lumbar spine and right hip, as well as some other issues. So I think that may qualify me but am unsure. I'm in chronic pain due to the back issues I have. I have arthritis now due to an accident in 2003 that resulted in back fracture. This extra weight sure doesn't help. Ready to be active again, I was a gym rat and a damn good soccer player. Weighed in at 155lbs when the accident occured and now am 247.
Starting Weight/ Surgery Weight
255 237
Go for it! you have so many health issues I think you have a good chance of being accepted..
I have had to go for a stress test because I get chest pains from time to time but the test showed I was fine and then they asked about my sleep habits and I dont sleep much but it is because of the pain..I turn and OMG instant pain in the hips and legs.. so thats mostly my problem other wise they would of sent me for a sleep test also. I have a friend that had to go for all the " lil " extra tests and she complained the whole time but the way I figure it if it is what I have to do to get rid of this constant pain and the high cholesteral and high blood pressure then I will do whatever it takes.. they are doing the extra tests for my benefit so I have no problems later on...it isnt doing anything for them...
I have found alot of people are not open minded about the surgery so you will need a very supportive group of friends around you to help you and also having OH has been a god send to me. I have met some great people from here that have given me thier knowledge so I am totally prepared. Good luck to you and dont worry so much about the insurance..Most of the surgeons know how to work around what they are looking for..
Good luck to you and keep in touch.. any questions just ask ...we are all in the same boat.. I start my support group meetings at Tobey next week and then they say anytime after that is my surgery.. so I figure end of February or March for mine.
Keep up the losing the more you lose now the faster the recovery I have been told. plus makes liver smaller for them to move it around lol...
I have had to go for a stress test because I get chest pains from time to time but the test showed I was fine and then they asked about my sleep habits and I dont sleep much but it is because of the pain..I turn and OMG instant pain in the hips and legs.. so thats mostly my problem other wise they would of sent me for a sleep test also. I have a friend that had to go for all the " lil " extra tests and she complained the whole time but the way I figure it if it is what I have to do to get rid of this constant pain and the high cholesteral and high blood pressure then I will do whatever it takes.. they are doing the extra tests for my benefit so I have no problems later on...it isnt doing anything for them...
I have found alot of people are not open minded about the surgery so you will need a very supportive group of friends around you to help you and also having OH has been a god send to me. I have met some great people from here that have given me thier knowledge so I am totally prepared. Good luck to you and dont worry so much about the insurance..Most of the surgeons know how to work around what they are looking for..
Good luck to you and keep in touch.. any questions just ask ...we are all in the same boat.. I start my support group meetings at Tobey next week and then they say anytime after that is my surgery.. so I figure end of February or March for mine.
Keep up the losing the more you lose now the faster the recovery I have been told. plus makes liver smaller for them to move it around lol...
Thanks for the info Mary! I've noticed some people think the WLS is the "easy" way out. But I'm a pretty self aware person. I'm going to do what is best for me and I don't need to surround myself with negativity. Ya know?
All any of us can do is our best with what we have, for me that means taking advantage of this tool and making my health and therefore my life better.
I hope you've had a wonderful holiday. Make sure to keep in touch!
All any of us can do is our best with what we have, for me that means taking advantage of this tool and making my health and therefore my life better.
I hope you've had a wonderful holiday. Make sure to keep in touch!
Starting Weight/ Surgery Weight
255 237
Hello!!!! Omg , finally someone else on BMC healthnet!! I am not on the masshealth portion (masshealth will not approve lapband, only RNY just an FYI for ya!), I have commonwealth care type 1 which means I still have copays for RX and stuff...
Anyway I am going to Dr. Hess too! He is awesome and ya know what? His nurse Tony is so comforting, kind, and caring... such a cute little guy. He really understands situations... Also you will work closely with Wendy who is the surgical dietician.. she really put me at ease this past Wednesday.
I was so excited to find you on here because the weight management center there is sooo busy yet I cant find anyone online who has had it there. It seems like they are all other places in MA.
I am having surgery in March and have gone through most of the process so contact me and we can chat!!! We should exchange AIM names or something... it really helps to talk to someone going to the same surgeon!
Anyway I am going to Dr. Hess too! He is awesome and ya know what? His nurse Tony is so comforting, kind, and caring... such a cute little guy. He really understands situations... Also you will work closely with Wendy who is the surgical dietician.. she really put me at ease this past Wednesday.
I was so excited to find you on here because the weight management center there is sooo busy yet I cant find anyone online who has had it there. It seems like they are all other places in MA.
I am having surgery in March and have gone through most of the process so contact me and we can chat!!! We should exchange AIM names or something... it really helps to talk to someone going to the same surgeon!
Most Active
Recent Topics
