New Member Looking for Advice
Hello all, I'm new to the group. I have been researching gastric bypass surgery for a little over a year now. I finally made the decision that I really feel this is for me. I'm 41 yrs old mother of 2 children 21 and 16 yr. olds. Happily married buh my weight has put alot of stress on my health, and everyday life. I called Medabolix Office and the lady that answered the phone was a sweetheart. She gave me all the information to get the ball started. I followed all her instructions, I went thru the seminars not just once but about 100 times now...LOL I probably know them both by heart. I then got all my paper work together, filled out the forms, got my diet history together and then I called my insurance, something I should have done first. For I see this is where it stops. My husband is an employee for A.T. Massey, we have BlueCross/BlueShield Insurance Anthiem. Well the gentleman I spoke with when calling to see if they covered this procedured was very nice, yet he informed me that NO my insurance covers nothing at all on it. Now I'm at a standstill because I'm not sure what to do. I don't know if everyone runs into this or if this is the only and final answer. I'm now very depressed and don't know what steps to take. So if any of you have any information that might help me, please respond let me know where to go from here. Thanks So Much Rhonda
Welcome Rhonda,
I know how you feel. But, dont let the discouragement get you down. Think of it as a temporary road block. 
I have been waiting for approval from my insurance for over a year now. My husband has Acordia/PEIA and there is so much red tape, its not funny. I was angry and disappointed the first couple of times I was denied and still dont have the go-ahead from my insurance company but you have to keep trying.
I am not familiar with your insurance company but a suggestion I would make would be to call the Medabolix Office again and see if someone there can give you more information. Most Physicians offices have specialists who deal directly with the insurance companies and know what is covered and whats not. Im working with Katie at Dr Shin's office in Charleston. Shes been bending over backwards to get things rolling for me.
It could be possible that your insurance company wont cover certain types of bariatric surgery. PEIA wont cover Lap Bands but will cover Roux n Y. With Acordia, you have to have ONE YEAR of weight loss documentation from your Primary Care Physician. And, I dont mean a little line in your medical records that says "Patient is on a diet". They want a mini novel about what youre doing and how youre doing it.
Keep your head up and press on. When the time is right, you will know it!
Jen
I have been waiting for approval from my insurance for over a year now. My husband has Acordia/PEIA and there is so much red tape, its not funny. I was angry and disappointed the first couple of times I was denied and still dont have the go-ahead from my insurance company but you have to keep trying.
I am not familiar with your insurance company but a suggestion I would make would be to call the Medabolix Office again and see if someone there can give you more information. Most Physicians offices have specialists who deal directly with the insurance companies and know what is covered and whats not. Im working with Katie at Dr Shin's office in Charleston. Shes been bending over backwards to get things rolling for me.
It could be possible that your insurance company wont cover certain types of bariatric surgery. PEIA wont cover Lap Bands but will cover Roux n Y. With Acordia, you have to have ONE YEAR of weight loss documentation from your Primary Care Physician. And, I dont mean a little line in your medical records that says "Patient is on a diet". They want a mini novel about what youre doing and how youre doing it.
Keep your head up and press on. When the time is right, you will know it!
Jen Most Active
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