a few questions

Hello all. My name is Beth, and I am 23. I have been trolling around here for quite some time. I have done research and decided that I am going to pursue WLS. My mom had the surgery in March 2005, and she has been supportive of my decision; in fact, she encouraged me to look into it. As a teacher, I would love to have surgery done in the summer months. I have a question about insurance protocols and planning a personal timeline. I just switched insurance companies and actually went without for about a month during the transition from school to my job. I wanted to know how far in advanced should I get the ball rolling? When you switch insurance is there time period one should wait before asking about coverage? Is it too unrealistic to want to have my own timeline? Any encouragement and other wisdom would be greatly appreciated. Thanks!!!

Beth, First of all welcome to OH! You will find a ton of very supportive and informative people on this board. I can speak only of my situation. I recently got married and changed insurance from mine to my husbands. I think it was effective around Feb. I would find out if you have a time period that you have to be at your place of employment before insurance covers you. Sometimes it's 30 days, but I've also heard 90 days. I went to the Informational Bariatric meeting on October 9th and then made an appointment with my PCP on November 2nd(first available) From there you can read on my profile which steps I had to go through next. Some programs are different but from what I've learned it takes about 3 months of appointments and waiting for your insurance to approve to the time of surgery. Today I meet with the surgeon and they should have already sent my packet into insurance. I will find out today. I should be looking at surgery in January if approved by my insurance. Also, if you want to get the process started and get approved you can plan surgery for the summer. There's no reason you have to do it right away. Hope I answered at least some of your questions! Good luck to you! Shanna

Another thing you want to keep in mind... what insurance does your new job offer and did they purchase the rider to cover WLS. Just a thought to keep in mind. Hugs, Chrissy

I would ask ASAP. If you are WITHOUT ANY insurance coverage for 63 days or longer then your new insurance company can slap you with a pre-exisiting waiting period. I would also find out if the policy will cover WLS - the HR should be able to provide you a benefits booklet that will say.

Beth welcome to the OH! from my experince I think you'll find that the approval process goes smoother when you have everything well planned out. It took me about 2 1/2 months to get approved and have the surgery. (I wanted to have the surgery done in the summer as well) The day after I went to my WLS Seminar I was on the phone with the Ins Co to find out if the surgery was covered and what they required. I wrote down names, dates and everything they said to me. I actually called them twice and spoke to a different person just to double check that I was still covered and that I had the correct requirements. I got a list of things that my surgeon required. I wrote a letter to my PCP explaining that I wanted the surgery before I went to see her. I wanted to show her that I had done my research and was going after this at full speed and that she could not discourage me. I got the first availabe appts to see the Nut and Psych Dr. I wrote a letter to my Ins Co I wanted to make sure that all my bases were covered. I did not want to give them an excuse to deny me. My surgeon's office staff were totally on the ball, they were working just as hard as I was. But things depend on your Ins Co and surgeon. The only way your really gonig to know is by calling them. I have to admit that I can be a bit of a perfectionist when it comes to things like this. Things just seemed to fall in place for me. Make sure you cover all your bases, do your research and be overly prepared. Good luck!

I had just started a new job in Jan 05. I was covered starting mid Feb and was looking into surgery by March. Ask asap - if you are covered, then you are covered - you arent denied anything just because you are new to the insurance company. You have just as many benefits as someone who has been covered for 5 years. go ahead and get the ball rolling

Hi Beth! and welcome to OH. I don't post too often, but I'm always reading posts and learning new things. My husband started a new job and 30 days after, our insurance was active. I would get started on the process right away by calling the insurance company and asking about coverage. Many insurance plans that cover the surgery require a 6 month medically supervised diet by either your surgeon or your PCP. If you start that right away you will be done by June. Hope this helps. Good Luck! Morgan

ASK ASAP! They can not punish you for asking. My insurance covered me and was very simple and fast. I am one of the lucky ones who didn't have to fight at all. There is nothing wrong in asking.

Thank you all so much. I was having one of my down days, but once I saw all the positive replies from everyone here my mood suddenly changed. My insurance did take affect after being employed 30 days, and I was only uninsured for a month. It's good to know that some of you were in the same predicament with the insurance company switch. I will be calling Tuesday of next week to find out from my insurance company. One of my coworkers had WLS a few years ago, so I am praying that it is still covered. I will definitely keep you all posted and try to figure out how to completely navigate this site as well as my profile to maintain some type of active status.

Start the approval process immediately. They don't wait to start charging you. Also before you request approval, call the ins company and find out what their WLS requirements are. If you know the requirements before hand, than you can make sure you have everything you need to get approval.