Question:
Is it impossible to have WLS covered by Humana Insurance?

I have Humana HMO Premier and i will be switching to Humana PPO as of Sept. 1, but yesterday i called Humana customer service line and one of the reps. told me that they very seldom approve this type of surgery, that it is a very close to impossible to get approved.    — theresa B. (posted on August 18, 2000)

August 18, 2000
Hi Teresa: I have Humana PPOM in Michigan and was approved with the first letter in less than a week. I brought up the Illinois insurers on this site and it appears that all but one Humana patient got approved for WLS, the only exception being if there was a written exclusion. Can you get your hands on the policy book before you make a decision to drop Medicaid? Perhaps a co-worker will share it. Look under Exclusions. That's where I found my WLS policy. It said excluded except in the cases of morbid obesity. Good Luck!
   — Allie B.

August 18, 2000
Hi Theresa!! At the time of my surgery, I had Humana PPOM. Probably a little different from a PPO, but, it seems they should cover at least closely the same!! My secondary ins. was Medicaid. They covered what Humana didn't!! I live in Michigan. I would do some thorough checking on you insurances!! Hope this helps!! Email me anytime!! [email protected] Take care!!! : )
   — Dawne H.

August 18, 2000
I have Humana/Med-cost preferred/PPO and I was approved on line within 24 hours after they received all my paperwork on pre-op.I did not have to do anything. It is listed in your Insurance as having to be medically necessary.You have to meet the criteria.
   — Debbie C.

August 18, 2000
I have Humana PPO and have had the VBG. I was covered for 80% untill my 2000 dollar out of pocket hit then they covered 100%. I had major complications and had to have two surgeries and they are paying it without complaints and I did get approved on the first letter. Kim [email protected]
   — Kim N.