Anyone have Emblem Health???

emery1217
on 7/23/15 9:10 am, edited 7/23/15 9:26 am

Hi, I decided to sign up cause I'm obsessed with this forum. I started my VSG journey on 6/17/15 and on the day of my consultation my surgeon gave me a surgery date for 9/8/15...he said my insurance requires 3 months of visits with the nutritionist and saturday will be my 2nd. I already finished all of the test and everything and the follow up with him is 8/20/15 so I guess that's when he will submit everything to the insurance company. I'm not sure if he gave me the surgery date because he thinks that I will definetly be approved or what...short history

19 years old turning 20 on 8/11/15

highest weight 223...lost 14lbs since consultation date...currently 209lbs

diagnosed with pcos at 9

diagnosed with high cholesterol at 10

pre diabetic since 10

diagnosed with high blood pressure and diabetes a day before my first consultation with the surgeon

been overweight since birth

Does anyone have emblem health and have been denied or approved? My biggest fear is they would deny me cause of my age even though I've been going through this for a decade and my doctors tried everything and obviously it's just getting worse. I'm 5'1" by the way so my starting bmi was over 40 that's what the surgeon will submit. I have HIP with HMO by they way...through my mom's job

 

Sparklekitty, Science-Loving Derby Hag
on 7/23/15 12:54 pm
RNY on 08/05/19

Pretty much everyone is in a different insurance situation, even if you have the same company; various workplaces have different setups.

If you haven't yet, find a copy of the benefit book for your/your mom's specific plan. That should have the list of exclusions and criteria required, and give you a better idea of what you're looking at. You can also call the customer service number on the back of the insurance card and a rep may be able to help you out with some guidelines.

Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!

emery1217
on 7/23/15 1:03 pm

Thank you I did that. Pretty much I have to meet their requirements which I do. The 3 visits with the nutritionist...my 2nd is on saturday, over 18 years old, cleared by the psychologist, and the significant comorbidities they have on the list that I have is type 2 diabetes, high cholesterol, and high blood pressure. I pretty much meet every requirement they have. I'm hoping they won't give me a hard time...but then again insurance always makes things difficult

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