Question:
any good insurance companies in Kansas that Will cover WLS?
I have blue cross and blue shield of kansas, and they will not cover one penny...anyone that can give me any information on other companies, im thinking about changing providers, ive had bcbs for yrs but if they won't help me, im not going to continue giving them my money. thanks for any help chas — chas1980 (posted on August 28, 2008)
August 28, 2008
Try Aetna. If they offer it in Kansas. They are suppose to be the easiest
to approve, and require the least i believe
— smittys13
August 28, 2008
thank you tina, i will def try it.
— chas1980
August 28, 2008
Before my husband had to choose his HMO I contacted each one to check on
gastric bypass surgey. We live in Texas and we used Atnea, I had to jump
thru alot of hoops to get them to pay but almost a year later and 8 lbs
from my goal it was worth all the phone calls.
— 102807
August 28, 2008
Good for you. I had BCBS and had to pay out of pocket for my WLS.
I think open season for changing with most insurance companies is in
November. I certainly would check into that if I were you. Also, check on
pre-existing conditions to be sure obesity is not a problem.
Good luck to you, do whatever you have to save your life,
Dawn Vickers, Rn, BLC, CLC
— DawnVic
August 28, 2008
Chasity, I have BCBS (Kentucky), and my insurance paid for the majority of
my surgery, etc. (minus deductibles)...I don't know if your insurance is
through work or self-purchased...but if it is through work, it could be
that the place you work has a rider/clause that doesn't allow for this type
of surgery. If it's self, you may want to discuss with them if it's the
type you are paying for that hinders them from paying...Good luck!
— BrendaMS
August 28, 2008
My insurance wouldn't cover it either (Group Health), even after several
appeals. Then someone suggested I try Department of Vocational
Rehabilitation (DVR). It took two years (primarily because my case worker
didn't really want me to have it, so she kept making me run in circles
having things done and redone - then I wrote a letter with a copy to state
director!) Anyway, they assigned me a different case manager who was
wonderful and within 2 months of getting the new case worker, they approved
my surgery so that I could continue working.
— Wendy M.
August 29, 2008
My insurance did not cover my surgery either. My bmi had to be higher and I
needed to have more medical problems. I was a self pay but I just wanted
you to know that the lap band surgery is actually unbelievably affordable
if you have to self pay. I paid 11,000 for my surgery. That is everything
included except fills after the first year. I also think you can finance
this too. People spend fifty thousand dollars on a car but dont think about
themselves enough to take out a loan to pay for a life changing experience
for themself. Dont get me wrong, surely if you can get your insurance to
pay for it..then try your best but if you cannot or cant wait that long,
self pay is a great option. It took me 12 days from the first time I called
my doctor to get my surgery because I did not have to go thru all the
insurance paperwork and extra requirements. I am 3 days post op and doing
well. I just wanted you to know that there is another option. If you want
to know more, contact me for the details.
— trbccowan
August 29, 2008
BC/BS POS paid all but $300 of mine
— pattschiele
August 29, 2008
I have Blue Shield PPO of California. They are paying for my surgery minus
my deducatbles. They have been very simple to work with and had
Authorization in less than a week.
Paula
— urbrat2
August 30, 2008
I have BC/BS and they will be paying for the majority of my VSG procedure.
The key is that BC/BS has certain requirement or criteria if you will to
qualify for consideration of bariatric surgery.
#1. BMI must be 45 or 35 WITH at least one morbidity ailment such as
Diabetes II, Sleep Apnea, or Hypertension
#2. If you wish to qualify at the lower BMI with one morbidity, you must
have had that morbidity for at least 5 years.
#3. You must have a MEDICAL HISTORY of attempts to lose weight. That
means that in your medical records with your primary care physician, the
subject of obesity has come up and perhaps notes on your losses and gains
recorded.
If you meet these pre-requisites, then you should find a bariatric surgeon
that is on the PPO list, (if you have that kind of coverage) and discuss
what comes next. My surgeon went over my medical history and medical
background (family) with me and came up with a plan, a roster of tests and
assessments that I had to complete before he would make a recommendation of
surgery to me. It took me 18 months, and during that time I was not
allowed to gain ANY weight from the start weight at the first appointment.
You talk about HARD! But I did it because this is what I want.
September 8th I will go in for the VSG procedure 40 pounds (or more)
lighter than when I first came to my surgeon's office. I still have about
110 or 120 lbs I would LIKE to lose. My surgeon has put together a
compelling arguement for BCBS, should they reject his bill later. You see,
my BCBS coverage does not do pre-approvals for this, so I am taking a leap
of faith that they will. And I believe they will because of my medical
conditions caused by the obesity that I have struggled with my whole adult
life.
All I can say is keep trying. Keep fighting.
— cydthekid50
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