Question:
Insurance??????????

Can anyone tell me how long it takes to get approved? I am a nervous wreck?? What are some resons why you would get denied???? Help    — thebabyrabbit (posted on April 17, 2008)

April 17, 2008
Insurance companies can come up with lots of reasons to deny surgery. You should be able to find out right away, however, whether your benefits cover bariatric surgery. If they do, then they should be able to tell you what the criteria is. Such as managed weight loss for 6 months, prior years of documented obesity, surgery with an authorized hospital, etc. Then you just have to start jumping through all the hoop both with the insurance company and the clinic. I can't even begin to go through the troubles I had. I thought it would never happen and then the next thing you know, the insurance company "changed their mind" and approved me, within a few hours I had my surgery date...the walls started falling down and the doors started opening. It's different with everyone though. Good luck. Chris
   — cjjordan

April 17, 2008
Some insurance companies don't cover bariatric surgery at all. Most that do cover it want you to prove that you have tried supervised dieting for at least 6 months before they will approve it. Some have certain benchmarks for approval like a BMI over 40 plus two comorbidities, i.e. sleep apnea, high blood pressure, diabetes, pulmonary problems... Even if everything goes well, it can take at least 5-6 months to get all the testing done to get approved. I began with a consultation on May 15 and had surgery on November 19 with no insurance problems, just lots of required Dr. visits, lots of testing, including sleep studies, breathing tests, psychologist consultations, dietician, pulmonologist, endocrinologist.... Be patient, make sure you are healthy enough for the surgery and work on the discipline you will need to have a successful outcome. Good Luck, Flora
   — MusigalF

April 17, 2008
Took 6 months for me. I got denied and appealed my decision was overturned due to my health problems. The insurance companies can deny you for any reason they feel. Good luck to you.
   — nascar_angel_3_2003

April 17, 2008
I think it depends a lot on your insurance...Check on your local state board in the forum section of this website...that helped me a ton. See if you can find your type of insurance and comments... I have BCBS and they are fine with the surgery..But I have to go to one of their centers of excellence... My doctors office is taking on a lot of that responsibility...and know what is needed too. By the way I posted about the same thing a few weeks ago...The post is titled AARGE...youre not alone...
   — [Deactivated Member]

April 17, 2008
I had Healthnet and it took less than a week to be approved. I work for another company now and have healthnet and they dont have bariatric surgery on the plan. My boyfriend has connecticare. He called and agve all his information to the girl. The girl told him he had to a 6 month medically monitored diet and he would be approved. Well he did it and then connecticare came back and told him it wasnt on his plan. I sent in 2 appeal letters, wrote to the commisioner of insurance and it still wasnt approved. The girl at connecticare should have been fired. So make sure you cover all of your bases
   — Joanc

April 17, 2008
I have BCBS of NC and once I had completed all their requirements it took seven days to get an answer back. I used one of their centers of excellance also which helped speed up the process
   — mochelle

April 18, 2008
I'm self-pay but I can tell you that insurance companies are designed to say no to the first request. They know that many people will just accept the denial and go away. Don't do that! Appeal! Appeal! Appeal! And good luck!
   — GlitterGal