Question:
Has ANYONE out there had surgery since 7/1/05?? WHAT INSURANCE CO??????
Nobody has responded to my question & I'm really wanting to know what insurance companies are covering gastric bypass anymore???????? — Shelly S. (posted on October 26, 2005)
October 26, 2005
I had surgery 8/22/05. My insurance company approved me in less than 24
hours in July of 2005. My insurance company is Paramount of Michigan and
Paramount Advantage.
— Rocquetta T.
October 26, 2005
I had RNY surgery 10/6/05 and Aetna covered it as out of network so I had
2000 out of pocket. I have the Open Choice PPO with them in Texas. Going
forward in 2006 they are only going to cover 50% of the cost. Good luck
with your search!
— akirsch
October 26, 2005
I had surgery Oct 4th and used my husband's insurance. We have HealthNet
POS. I opped to use the PPO portion, so my out of pocket is more than if
I had used the HMO. I didn't want to wait for referrals. I was approved
within a week. Surgery was 4 months to the day that I started the whole
process. Best of luck to you.
— butlers4
October 26, 2005
I had surgery on August 8th through Aetna POS.
— *Malena* M.
October 26, 2005
My surgery was 8/16/15. My insurance is United Health Care. I had a $1000
deductible.
— singingcoyote
October 26, 2005
I am scheduled for surgery on 11/1/05, I have Blue Cross Blue Shield PPO
Commuity Blue (Hubby has PPOM) both will cover. Good luck!!
— April
October 26, 2005
I had surgery April 29, 2005.
BC/BS of NY covered.
— andi4883
October 26, 2005
I'm having surgery on 11/7 and mine was approved in less than 1 week by
Aetna Open Access (VA).
— sherita
October 26, 2005
hey, i had surgery october 17th, and i had horizon blue cross blue
shield.... i'm under my parents insurance, so in august we had horizon ppo,
and i was approved instantly, then we changed to horizon hmoin september
(parents changing jobs), and approved instantly again. my family,
personally, likes horizon. the co-pays are cheap and getting refferrals and
everything is really easy.
— ClaireMarie
October 26, 2005
I have Oxford and so does my daughter and we were both approved for the
surgery without any problems at all.
— patgels
October 26, 2005
I had my surgery Sept.29 2005 and I had Community Blue Advantage and they
have been great so far . I was approved in less than 3 days and they even
wished me luck!!!! Also they called me at home to tell me I was approved
how nice is that?
— sunnie
October 26, 2005
I had surgery 07-05-05 and I was covered by United Healthcare. The whole
approval was done over the telephone, and was very simple.
— kaitlain
October 26, 2005
I am scheduled for Laproscopic RNY in 11/05. I have Kaiser Permanente. I
had to go through a lot of workshops and evaluations. It all took about 7
months, however the only out-of-pocket cost to me was $40. I have several
friends that have had the surgery this year. They were covered 100% for
surgery under PacificCare. Good Luck!
— Michelle R.
October 26, 2005
I think that Anthem Blue Cross Blue Shield will cover the surgury if it is
medically necessary. I am not sure about other insurance compaines. I know
that one the website most people have listed what types of insuraces that
have. Have you checked on there?
— kizie23
October 27, 2005
I am having surgery on 11/7/05. My insurance (Illinois medicaid) is paying
for everything. My insurance covers it if it is medically necessary. The
hard part I had was finding a doctor that took my insurance. That is where
this site helped me out. I am going to the Cori Centers. See there info at
www.weightlosssurgery.com. It is very resourceful.
— j_m_easter
October 27, 2005
I had surgery Sept. 20th and we have Wellmark BC/BS and I didn't pay a dime
because I had met my $250 out-of-pocket already. I was truly blessed by my
insurance. Good Luck!!!
— REDHEAD
October 27, 2005
I had surgery (RNY lap) on 10/03/05. My insurance is Cigna HMO! Didn't
have any problems!
— momsluv2
October 27, 2005
I just got my approval yesterday, it took about 2 weeks. The requirements
were pretty easy... 6 months of failed diet attempts & a BMI of 40 or
greater & a cleared phys evaluation. I have Preferred Choice is
Michigan.
— KimY
October 27, 2005
i had principal financial insurance. i had to pay $2000.00 out of $40,000.
give or take a few dollars.
— karrie777
October 27, 2005
Scheduled for surgery, 11/11/05. I have Health America. Started all
testing in May, finished the end of August and submitted to the insurance
company first week in September. Was approved in 1 week.
— Debbie C
October 27, 2005
Oct 4: TRICARE PRIME (military)
— Ravenwulf
October 31, 2005
Insurance companies will pay for whatever your employer chose to buy
coverage. In order to lower premiums or to keep them from rising, more and
more employers chose insurance plans that do not cover certain procedures.
Many employers consider it smart to exclude procedures they consider
elective (you can have many arguments about the long term savings).
In other words, you need to convince your employer, not your insurance
company.
If your plan includes coverage, but you have problems with your insurer,
then you have a number of options: complaining to your employer's plan
administrator, the insurance commissioner, hire a lawyer, etc.
If you go down that road, make sure that you have complied with any
"reasonable" requests for prior treatment and documentation from
the insurer.
— aferda
November 2, 2005
I had AmeriHealth. They pay 100% but their coverage area is mostly in NJ
and PA.
— Country G.
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