Insurance

Auntie P.
on 8/8/05 8:41 am - Wheeling, WV
How do I know if my insurance will cover the surgery? I haven't talked to my pcp about it yet, I guess that's where I start, huh? I'd hate to get my hopes up just to be turned down by my insurance... Thanks for any info! Paula
Janet H.
on 8/9/05 5:57 am - Huntington, WV
When I first anticipated surgery, I called my insurance company (America's Choice Healthplans) and asked if they covered the surgery. Their answer was "the Dr. would have to submit information to make it medically necessary". So since that wasn't a "no" I took a chance and pursued it. I called Dr. Stickler in Chas. and started the process. It is a chance you have to take. But thankfully my insurance approved the surgery. Last week my husband's insurance sent an addendum concerning the requirements to be approved for surgery. His insurance is Acordia. Hope this helps.
batwood
on 8/13/05 4:03 am - Almost Heaven, WV
Start by calling your insurance company. They have different requirements and you want to do exactly to the letter what they say they need to approve you. I have Aetna POS... with them you need 6 months physician monitored weight loss program... or a 3 month interdisciplinary program. I"m doing the 3 month with Dr Stickler. Each insurance is different. You could always ask them to mail you the information. Aetna has 'on line' their Clinical Policy Bulletins that lead you read everything line by line. I recommend getting that first so you know what direction to start in. It's like a road trip... you have to have a map to know how to get there! Good luck and keep us posted! ---Barb A
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