IMPORTANT INFO FOR PRE-OPS!!!!

I just posted this on the main board, but thought it was important enough for a repeat: My friends experience: She contacted the surgeons office. The insurance assistant checked the insurance requirements by using the Internet. My friend was told that her insurance company required a 12 months monitored weight loss program. My friend called her insurance company to verify exactly what was needed to meet that requirement. She was told that since she works for "this particular" company, the pre-certification/pre-approval for surgery is done by a different insurance company. She called that insurance company and was told that the only requirement was that the doctor states that surgery is needed. She then call the doctors office back with this info. They called the second company -- and, guess what: NO 12 MONTH MONITORED WEIGHT LOSS PROGRAM!!!! Moral of the story: CHECK EVERYTHING FOR YOURSELF!!!!!

Hey Judy, Very nice of you to post this. Good on your friend for following up and getting a better response than the first one. That is excellent advice for preops. luv, Carole

Excellent point Judy! This is often the case for large companies. They are often "self insured" through (for example) Aetna. That's how mine is. The corporation actually makes their own rules for the plans that they are offering. They use their large buying power to negotiate different terms. If I go through the regular Aetna site, many of the rules don't apply to my plan. This applies to many things besides WLS. Christine