Insurance & Financing

Does anyone know what documents your gastric bypass surgery send Medicare for approval

Anyone has Aetna ins. how long did it take for you to get approved and what were the required timeframe to wait for surgery?

Hi sleevers! I decided to start the process of getting the things checked off my "to-do" list that seem pretty common (nutritionist, psychologist, PCP...etc.) even though I am in the process of waiting for a background investigation to clear for a new out-of-state job. I actually researched the requirements for the VSG for the insurance company that I will be switching to, and started making my appointments. I guess my only concern is whether or not these things will transfer, or if I will have to start the process all over again when my insurance company switches. I will be switching to BCBS Federal (I am getting a job teaching for the Department of Defense) so the…

Yes I'm new here and I just found out today that my health insurance will not cover my wight loss surgery I waa approved for it but my healthy insurance didn't pick up the plan this year I don't understand if I started in 2017 y My insurance company want pay I'm with Florida Blue I'm so mad and have lost all of my faith because I feel like I have went through all of this for nothing looking for someone that could help me r a insurance I can pick up interested in anything right about now I really do need help Please

Anyone get approved for gastric sleeve through Medicare? If so, what were your out of pocket expenses?

Does anyone have this insurance. City of New York employee

Anyone have BC/BS Federal and had a BMI less than 40?

Anyone have any experience with this? I've had Cigna throughout the process and my surgery is scheduled for November 1. On September 28th my husband's company informed the staff that a new insurance company was taking over on October 1st. I am working on this every day and we are hoping for the best. Initially they said if we could provide the approval letter from Cigna that they would automatically approve me. However, we never fully submitted to Cigna, that was set for October 1st. The new company is Fallon Health, they are located in Massachusetts which is where my husbands employer is based. Any tips greatly appreciated.

Anyone trying to get approve with a 35 bmi and 1 comorbidity???!!!!

I’m looking to reach out to anyone that started this process with a BMI under 40. I have a couple maybe three comorbility factors. The reality is I feel horrible and I have struggled with my weight for many years. I hit a plateau and never budge. My doctor referred me but my BMI is 37-38. What should I expect?

I have my first appointment on December 22nd to get the process started for Gastric Bypass. My current health insurance is Arkansas Medicaid. Gastric bypass is covered with requirements. There is one thing I am not too certain about and in the requirements it's not very clear. Some people I have seen that have medicaid say that they have had a referral from their PCP. The billing specialist called me last week and said I needed a PCP attached to my Medicaid. I just got medicaid at the beginning of this month and had not yet done it. So, when she called I got a doctor set up as my PCP. I called the billing specialist back and told her I got a PCP attached to my Medicaid. I…

My surgeon requires exercise and nutritionist clearance. However, my insurance—Anthem BCBS— does not cover these appointments. So far the exercise counselor is making me come back for a follow up. I see the nutritionist for the first time next week. How many time did you have to go back until you got clearance for exercise or nutrition?

Has anyone been approved with Magnacare Ins. through local union#3? I just finished my request criteria , just waiting on approval?

Has anyone on here had their surgery at the bariatric and metabolic institute at the Arkansas heart hospital? Looking to have surgery in Arkansas or Northeast Texas.

My Husband and I were both interested in the vsg for our weightloss His BMI is 58, mine is 56, He was laid off of work and we are on Medicaid. At our first consultation we were informed that medicaid in our state does not cover the vsg, yet when I called them I was told that it was covered if it was medically necessary. My only options are Bypass or Band. So, next I thought maybe we could afford to add coverage and pay a premiums. So I checked out bcbs the sales agent said we would be denied until after we had the surgery if it was recommended by I doctor. Well my primary Care physician did write us a refferal.... so did I just blow it? What are my options ? Ca…

The 2018 benefits book for my employer just came out and it says “if pre-service authorization is received, the medical plans cover gastric bypass or lap band surgery if specific criteria are met” slightly nervous. But my patient coordinator at my surgery center knows I want the sleeve and provided me with my insurance requirements. Maybe it’s just poor wording?

I am in Kentucky and have Anthem Blue insurance. I have called my insurance several times and keep on getting different answers when I ask about their insurance approval policy for bariatric surgery. They say they cover bariatric surgery and say that I just need my doctor to say it is medically necessary. All the information given to me about the details of BMI, and weight loss program information varies each time I speak with a person. One person said whether I can get surgery depends on my BMI. Hoping to get details, I asked how. They said that if my BMI is very high then I'd need to lose weight for the doctor to perform the surgery (I think she just made that up, …

Looking to see if anyone has any insight on Cleveland Clinic employee health plan and getting approved. My story is complicated so let me know and I will explain. Thanks!!

I haven't seen this topic recently. Anybody recently approved? If so, how long did it take after paperwork submission? Thanks in advance!

Just began process in December. Have HAP insurance and curious if anyone out there in Michigan had sleeve with HAP and what experience was.

"Within 12 months prior to surgery, a thorough nutritional evaluation by a physician, registered dietician, or other licensed professional experienced in the issues of bariatric surgery, who has had a meaningful conversation with the individual regarding the dietary and lifestyle changes required to ensure a successful outcome over time." I copied and pasted this from my policy and I did a search of 12 months and 12 consecutive months in the PDF. It does not mention12 consecutive months anywhere in the policy for bariatric surgery. I would like to know, in your opinion, how does this read to you. Call me crazy but…

Hi all, I am just beginning my exploration into bariatric surgery, and am trying to figure out the insurance logistics of it all. The BCBS RI website isn't very helpful besides to say the surgery is covered after my deductible. Does anyone know if they have the 6 month nutrition requirement? I have seen people from other states say the requirement has been removed from their BCBS, but nothing for RI. Also, what about all the preliminary tests and appointments? Are copays due for all those visits? I plan to go through Miriam hospital if I decide to do it. My initial consultation isn't until November and I am trying to research as much as I can before then.

Just got notification from my surgeon’s office manager advising me that I had been approved for revision from Band to bypass. Request was submitted Monday, with approval received today, Wednesday. My requirements were 3 nutritionist visits, psych, and 2 years medical history. I was very surprised at the speed in which my approval was given.

Does anybody have IEHP? SoCal. Sent from my iPhone

Hello all!!! I am currently working on completing all the requirements for BCBS and DS weight loss surgery. I've completed 5/6 monthly dietician visits, the psych consult and so far have lost 23 pounds. I started at 433lbs. I'm nervous about the insurance process. What if they don't approve the DS and I've gone through all of this for nothing? I'm sure it's irrational, but I am just so stinking close!!! Anyone else with BCBS MN coverage have luck getting the DS approved? Sent from my SM-G955U using BariatricPal mobile app Sent from my SM-G955U using BariatricPal mobile app

Anyone with this insurance have any insight to the approval process and their criteria? I'v heard its one of the more easier insurance companies to deal with and get approval from. I have my consult with my surgeon next week and I'm just praying its not another waste if time like my first go-around was. I had MVP and a diff bariatric group and it was a total waste of 6mos. Any info would be greatly appreciated.

Hello everyone! I am kind of nervous. I met with my surgeon in OCTOBER 2017. I have done the pulmonary/sleep study, the gastroscopy, met with my nutritionist the 1st time on Dec 9th weighed 200. Met with her a second time this week on JAN 9 TH and i had lost 6lbs. I am doing my lab work today. Have my preop scheduled with my surgeon on monday the 15th, and see my Primary care for medical clearance on Friday the 19th. My surgery is scheduled for FEB 13TH 2018. I have done everything. Now i have to wait until after my pre op to they will submit everything to insurance. What are yall's exprience with masshealth approval. I am soo soo nervous.

Kinda a personal question, but I was wondering what the rough estimate of out out pocket expenses is with Cigna? I have my first seminar on the 21st and hope the next 4 months flys by after that (IF I get approved!). I have Cigna and my deductible is $500. I know the prices vary by doctor, state, hospital, etc, but just a rough estimate would be great!

Hello! Anybody have any experience with the New Jersey Horizon Omnia BCBS approval process? Just curious since I think my doctor will be submitting for approval this month or early next month....

I was approved by my insurance (BSBCIL), but now I am very confused about what part of the cost I will be responsible for. My deductible is $750. Coinsurance 75/25. Out of pocket is $7,150. When I spoke to the surgeon's office they said for example if I had surgery that day since I had not met my out of pocket that the hospital would ask for the entire $7,150. Which is a little (a lot) more than I was expecting. I was under the impression that I would be responsible for the deductible, and then 25% after that until it reached out of pocket max? Please help me understand! Sent from my iPad using the BariatricPal App

Does anyone have blue cross blue shield anthem health savings account insurance. I did some research turns out my insurance covers the procedure however I have a deductible of 2900 and a max out of pocket of 6500. Can everyone share your experiences with the hospital what were you required to pay day of surgery? Was it your full deductible? I asked my surgeon office but no one is really giving me a straight answer and I would like know what to plan for as I am 6 to 8 months out from having surgery. Any feedback would be greatly appreciated.

I have Cigna and have been told that most plans require a 3 month diet, but sometimes, certain employer policies do not require it. I am assuming mine does but I am just curious. If you used Cigna for your insurance, did your policy require a three month supervised diet. (I will find out the specific requirements on Monday)

Just wondering if anyone here has gone through or is going through the process of getting approved in Connecticut and has husky insurance. I am just starting my journey and I may have the opportunity for a full time job with benefits, but I currently have husky d. Just wondering how likely I am to be approved on husky/Medicaid? Sent from my iPhone using the BariatricPal App

So, I'm just starting this, like I'm talking to my doctor about this in two weeks. She's mentioned it in passing before, but I've never really wanted to until this last year. Anyway, I have a BMI of 40.2, co morbidities of pre-diabetes, depression/anxiety, GERD, and chronic gastritis. I have Wellmark BCBS of Iowa for my primary insurance and Medicaid (Amerigroup) as secondary. I am extremely nervous whether I will be approved or not. My 100% co-morbidities are pre diabetic and depression/anxiety. I was told I had acid reflux by my old doctor, but never officially diagnosed. My chronic gastritis was first diagnosed as gastritis while I was pregnant with my first,…

Hello, I'm new here. I'm getting new insurance starting in the new year. I'll have Medicare with Anthem Mediblue Access PPO (I am disabled with mental illness). I have some questions about insurance approval. These are the bariatric surgery requirements for my insurance: For Part A- I have a BMI of 42, so I meet that requirement. For Part B- I have not had a primary care doctor for about 3 years. I go to clinics and the ER when needed. I have tried various diets, and have been using a Fitbit for the past 2-3 years. I do not know if this is enough for my insurance requirement though. For Part C- The mental health requirement; I do not tak…

I have 1 more month to finish my insurance requirements and I have heard some people don't get approved. I've seen the nutritionist, got a psych letter, doing an endoscopy tomorrow, did all the bloodwork and abdominal ultrasound and need 1 more PCP visit. My BMI is over 40. Any pointers or input regarding this insurance? Sent from my SM-G955U using BariatricPal mobile app

I went to my PCP on Dec 15 to get the referral for a bariatric surgeon. We discussed my weight and how to best lose it, and she gave me the referral even though she is against weight loss surgery (for anyone). I have a three month diet requirement, and my bariatric surgeons program sets all of that up for me. My question though is whether I can use the Dec. 15th appointment as my start date of the three months, or do those appointments all have to be with same provider? I prefer to go a dietician for those three months and I will not be returning to my PCP for several reasons. I will be setting up a new one at the beginning of the year.

Anyone know how long take for approved? Thanks Sent from my SM-J700T using BariatricPal mobile app

*sorry, 1st post* So I'm wondering how long the process is for BCBS in order to get the surgery. Right now I have Cigna but next year my job is switching to BCBS. I asked the Doc & he said Cigna takes 4+ months but BCBS takes 2+ months. The checklist they gave me seems easy enough to get done. Do you have BCBS? How long did it take you to get your surgery? 2 months seems too easy. I don't want to get my hopes up. [emoji21] Sent from my SM-G955U using BariatricPal mobile app

I was wondering what everyone's Experience is with Insurance approval if they have a lower BMI (BETWEEN 35 and 38) with no co-morbidities. At At 1st I just assumed that I was going to have to be a self pay client, but after a little more research, saw that maybe I could get insurance cover it. I currently have Florida Blue. anyone have any experience with this? Sent from my SM-G892U using BariatricPal mobile app

Hi Everyone I have Aetna insurance with HealthCare Partners and having issues getting a an approved referral just to go to a bariatric surgeon. My PCP said I wouldn't have a problem but unfortunately I am. I am 4'11/193 lbs with a BMI of 38.7 with health problems such as joint pain especially in ankles, stress incontinency, etc. My whole livihood is going down the drain, and believe me I work out 4 times a week just to make sure I do not gain anymore weight as I'm pushing into 200 lbs and it's scary. Thanks Sent from my SM-N910T using BariatricPal mobile app

Hello! I'm new here just looking for some answers I hope to find...but I'm 5'6 and weigh 260 pounds. my BMI is a little over 40, I believe. I have sleep apnea, but no other comorbidites. Unless IBS or stomach problems count? I have medical, since I am low-income, under LA CARE. I was wondering if anyone here has had this procedure done or know if it is covered by this insurance? Also, how could I start the process? unfortunately at the primary doctor I currently have, it takes so long ti get an appointment, so I was wondering if I could start elsewhere? Thank you everyone!

Are you in the process or have already gone through the process. The guidelines say I have a 4-month period from the day of the seminar to get a surgery date??? Did anyone have the surgery 4 months after actually having this process... And how long were you approved to be out?? They told me they cover up to 12 weeks of S/T disability...

Hi my name is Vanessa and I have made a YouTube channel about my gastric sleeve surgery go and follow me.. and tell me about your surgery [emoji16]... Thank you Sent from my SM-N950U using BariatricPal mobile app

hi everyone! I just started the process of getting approved for surgery. I have an HRA with United Health Care through Wells Fargo. While the insurance specialist at my office is working on obtaining her sign on for my insurance to verify benefits and requirements (the center I am going to just became a COE for my plan a few days ago), she had me call my insurance to verify. They advised me that there is NO diet requirement - just the basic testing, psych evaluation, and the BMI/co-morbidities. When I called her back to let her know today, she said that sounded pretty odd because almost EVERY insurance requires it. Does anyone on here have experience/information with the …

I was sleeved in 2015 my surgeon wants to convert to bypass because of severe GERD and hiatal hernia. I have Aetna and yes I know they'll cover revision. However was wondering if anyone with Aetna have a sleeve to bypass revision? If so how long did approval take and we're you required to do the 3 or 6 month program for nutrition?

So, I'm scheduled for surgery next week, December 14th, but I'm still waiting for insurance to approve. All of my paperwork was sent on December 1st. I CANNOT take the wait. I try so hard not to think about it but it is CONSUMING me

Anyone used United medical loans for financing? What are your thoughts?

My BMI is 40.1, my NUT said I can't lose any weight before surgery (which has not been scheduled yet). I have gone through all but 3 out of the 17 requirements from my doctor. (EDG, sleep study and a cardiology clearance are left) How do I maintain my current weight with the 2 week pre-op diet coming up? I have BCBS CareFirst of MD.. they require a BMI over 40 unless I have a pre-existing condition.Insert other media

I have united health care community plan has anyone had problems getting approved for sleeve? Im located in ny Sent from my LGMP260 using BariatricPal mobile app