Jump to content

Hello! Welcome to the Largest Bariatric Surgery Community Online!

Welcome to BariatricPal.com, the largest Weight Loss Surgery social network in the world! Our goal is to provide a unique platform for Weight Loss Surgery patients and potential patients alike that enables you to make informed choices involving your Weight Loss Surgery decisions as well as providing you the Weight Loss Surgery support you need to meet your goals. Sign up now to access exclusive BariatricPal member features!

Join our 250K+ WLS member community. It's free!!!

HELP!!!! Does anyone have medi-cal/medi-care..or molina insurance??

August 25, 2010 by shayna_bayna

:wub::eek::thumbup: So I switched over from Kaiser Permanente insurance because I heard that Molina insurance covers bariatric surgery...I feel as though I'm getting the run around but I'm not too sure. How do you go about the whole process. I talked to Molina and they said I have to do 24 classes of Weight Watches.. which is fine but they span over a period of 6 months..and I still have yet to receive the voucher for weight watchers from Molina..Is there any loop wholes that I'm not seeing?? Can I go straight to the surgeon and get in there faster?? And is there any other insurances on Medi-Cal/Medi-Care that cover bariatric surgery??? ie. Aetna... Community Health Group...

4 Comments / 1,624 views
Share this Topic with all your Friends:
I know if you have medicare they would be consider your primary insurance and to my understanding just as long as you have a medical condition. You are approved...

with medicare there are three easy steps.

1. Medical condition
2. Do you have medical history to show you have been obesed for a few years
3. Have you tried in the past to loose weight. Such as Jenny Craig, Weight Watchers....etc.
Hi Shayna

There are different steps you can take as far as getting your procedure covered. I have experience in the insurance industry so I’ll give you a little bit of my knowledge. You may already know some of this information. You may send me a message if you feel your questions and answers are too personal.

1. Are you on an individual or group sponsored health plan?
2. If your group health plan is the group is the health plan self-insured or fully-insured. (If you work for a large corporation most likely your plan is self-insured and the best place to start is your HR Department). If you are on a group plan and the plan excludes the surgery ask the HR Manager/Director if they are able to amend the health plan next enrollment to include that procedure.
3. If you are on an individual or small employer plan call the prior authorization department and ask if the following CPT codes are covered under your health insurance contract; 43770, 43644, 43645. There are more CPT codes, but those are some of the normal codes used for the Lap-Band procedure.
4. If the insurance company said they will NOT cover Lap-Band that means your insurance excludes that procedure and they will not approve.
5. If the insurance company will consider you for approval, I’m encouraging you to follow their requirements to the “T” or you will be fighting for months with appeals. This process takes several months because a lot of plans require you to try other weight loss options.
6. Go to a bariatric seminar in your area and choose a surgeon. Their staff is the most knowledgeable and they are familiar with the insurance carriers’ rules for your region and they will be able to guide you through the process. I encourage you to pick a surgeon with a team that is actively involved because it makes this process a lot easier. Also, see if your insurance carrier has a preferred surgeon for the procedure because his/her office will be able to receive approval faster than others.
This is just some suggestions but use your best judgment. I wish you well during your journey.

Aetna cover bariatric surgery. I was approved in 1 day.
aetna with medi-cal?? did you have to do 6 months monitoring you weight.

Recent Entries

  • Photo
    The Pilot

    Back in 2006, I decided I wanted the lap-band.  I thought it would make me happy.  Back then, I was alway...
    redbean414 - Today, 3:30 PM

  • Photo
    Post-surgery Pregnancy Struggles

    I watch the scale creep up.  Sometimes, well really for more than half my life, the scale has been my enemy. ...
    Kristina Mccarthy-Martin - Apr 21, 2015 8:57 AM

  • Photo
    There is additionally a woven patch

    There is additionally a woven patch behind the tongue, reading, "engineered and designed to the exact requirements of Mr. He...
    kellyleiva - Apr 21, 2015 2:00 AM

  • Photo
    5 months and counting

    I am down to 182 this morning... My weight lost is slow but steady. Seems I stay the same weight for quite a while then drop...
    MariaW - Apr 20, 2015 10:55 AM

  • Photo
    Springtime 2015

    Hello Lapbanders,   Well my weight is finally lower than its been since the 1990's. My journey has not been a straight l...
    MaggieGT - Apr 19, 2015 9:05 AM

Recent Comments

  • Photo
    Post op day 9

    Hello mykidzmom!  When is surgery?  I just had my 2-week postop check in with my surgeon and my nutritionist yester...
    Sreeves - Today, 4:22 PM

  • Photo
    Post op day 9

    Oh my, please don't use anything that has sweat in it!  LOL.... I meant sweet... I need some coffee :)
    mykdzmom - Today, 8:23 AM

  • Photo
    Post op day 9

    Sounds like you are doing great!  I need to order some of that Unjury Chicken Soup before my surgery.  Most of the...
    mykdzmom - Today, 8:22 AM

  • Photo
    5 months and counting

    Congratulations on your success and the new grandbaby!  So adorable!
    mykdzmom - Today, 8:18 AM

  • Photo
    Let's Begin

    I invite you to check my youtube channel or have a consult with me, so you can understand better the good, the bad and the ug...
    Dr Altamirano - Apr 19, 2015 1:36 AM

Together, we have lost...