Insurance & Financing

How or where did most of you self pay people get the money? I've looked into care credit and they won't even tell you the interest rate until you charge the amount to the card!! OK I'm not crazy and I would NEVER take out a credit card without knowing the rate. So I passed on that one. Medical financing was better rates and length of loan but they wanted $1,500.00 in cash up front just to give you the loan...that's on top of the interest rate.theres got to be a better way to finance the surgery. What did you do?

Hello everyone, I'm Lena from Michigan. I have an appointment to attend a seminar at Beaumont in troy. At 341 lbs, I am deciding to get sleeved. My husband just added me to his insurance plan through blue care network. He hasn't been to the Dr all year so we both have separate deductibles $500 each and $3000 out of pocket max limit each. The surgery is covered and I guess I'm responsible for 10% coinsurance for the surgery, 10% coinsurance for hospital inpatient admission. I have a bmi of 51 so they are waiving the 6 month medical supervision. My question is, does anyone else have bcn? I wanna know how much did you have to pay out of your own pockets? What other expens…

Has anyone had issues with weight gain during the 90 day nutrition and getting denied? My weight has been crazy with going back and forth and I have my final visit weigh in tomorrow and know I'm 3-4lbs higher than my previous weight. Of course I had thought my previous weigh in was my final one so I didn't follow my eating plan as closely as I should have since birthday and all going on.

Hi! I'm new here but I have been on my journey to get approved for WLS since May. My Doctor's office submitted all my paperwork on 09/11/15 and I just got the call today that Cigna denied it, they said that it was denied stating I didn't complete my 90 days of supervised nutrition. I went through a registered dieticianand had my first meeting with her on 05/16/15 where we discussed healthy eating, exercise, and took my weight. She sent me a meal nutrition plan and I started on my merry way, I saw her again on 06/18/15, 07/31/15, and 08/22/15 in which we discussed the same thing and she went over what I had been eating, my exercise along with taking my weight. I figu…

I have Cigna insurance... I am getting close to my Dr submitting for approval for surgery...how good is cigna at approving for surgery? How long do they usually take to decide approved or denied?

Hi just recieved a denial letter for lap band because of a wrong psych evaluation? I went to the Dr. my surgeons office uses? Is this another ploy by the insurance to deny my procedure? Just wondering if anybody else ran into this problem.

Hello, I'm in the middle of my process. I currently have Cigna and they cover bariatric surgery with a 90 day supervised diet. I did all of the other requirements and just waiting on time. Next week is my 3rd consult and the bariatric center I'm visiting likes to add a 4th visit to ensure the insurance company won't deny it. They said Cigna is pretty good. Now I'm in the process of getting a new job (unexpectedly). I asked about their insurance and they have United. I'm like freaking the heck out!! I might turn this job down, (even though it's a better career opportunity) because I keep reading that UHC doesn't cover it. I figured I would come to the experts, you guys. …

My insurance told me yesterday the request was for Oct 19. My dr didnt tell me that. Should I tell my job?

Can anyone refer me to a gastroenterologist for a hiatal hernia in NY . I need to get an Upper GI for insurance purposes.

Today I found out I was approved... With cigna it only took 5 business day. Im so excited. Surgery date July 14th....

Has anyone had any luck with them approving? They posted this PDF last month http://blue.regence.com/trgmedpol/surgery/sur58.pdf but my plan excludes bariatric surgery... as do all plans in utah.

I'm so frustrated. My bp is boiling. I took the big step to decide to get lap band. Met with baratrics coordinator. I have all those tons of test appointments all scheduled as of today. My bcbs IL even covers baratric surgery. No issue there. All my tests are covered. All good. All in network. Now I was told if the hospital- where the dietician is- bills insurance as outpatient hospital for my required 6 visits- it will NOT be covered by insurance. These visits are required by the baratric program not bcbs. I have been on phone back and forth trying to find out how they bill and not getting much help. No one knows. Finally had bcbs put me on hold and they called the ho…

Has anyone ever had this insurance? Curious how long approval is and if there is 3 month period..

Ive had the band since last October. Im going on a year and all I do is get sick. This is like controlled bulimia and Im over it. Fluid, no fluid, Ive only lost 35 pounds. This band is making me sick all the time. Has anyone ever had this issue and has medicare? Any info would be fabulous. Thanks!

I have Horizon Nj Health and would like to know how easy is to get approved? Did anyone had any problems? What do they usually require? Tia

Quick question.... I've just started my process and have only seen my PCP and the bariatric dr. that I will be doing my procedure(I've only been to see him once) my insurance requires a 9 month pre-op and I'm now receiving bills from my PCP which I've never had a problem with caresource covering. I'm wondering if my doc saying anything about bariatric anything in the submissions to insurance is causing them to deny those visits. Should I count on paying for those visits or should I contact my insurance and see why they are denying?? So confused!! TIA.

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My daughter moved off Kaiser and now has Anthem in the LA area of California. Any suggestions for a PCP who takes Anthem and will refer to a plan Bariatric Surgeon? Thanks!

Hello! I am in the mid-point, I hope, in my journey toward WLS. I am new to the forums here as well. I have Mclaren Healthy Michigan Plan and I am wondering if anyone has had any experience when dealing with the insurance company on getting approval and their requirements? I started my journey three years ago diagnosed with uterine cancer after 10 months and was told by my oncologist that I had to wait a year before moving on with WLS. That incorrect information has caused a delay and may be a problem for me. I will be calling the insurer Monday but I am wondering if anyone had first-hand experience with them. Thank you in advance and have a great evening!

Ok so my insurance denied me because my BMI was only over 40 for 3/5 years! How can I appeal this??? My plan states that it must be over 40 for 5 years in a row.

Can anyone tell me if they know of a surgeon who will do the surgery with a BMI less then 35 with no issues. Yes, self pay! Frustrated.

My surgeon missed the Peer-to-Peer review to discuss my case!!!!!!!!!!!! SHE MISSED IT!!!! No one could find her -- they couldn't even find her PA. Now they can't reschedule it until May 20. I'm sooooo upset!!!! I have a lap band which has malfunctioned, but because I have a bmi of 38.6 and no "listed" co-morbidities other than asthma, pedal edema, and a major case of GERD, the insurance company denied my initial request for revision to gastric bypass. I've had a bilateral mastectomy and kidney cancer as well within the past 3 years, along with a knee replacement. So a Peer-to-Peer was scheduled for today and SHE MISSED IT!!!!

Well I'm giving this a shot. I live in Florida I had gastric bypass December 3rd 2014 medicaid paid for it (staywell) I was wondering if anybody has share of cost and had surgery done with it. Which is medically necessary. Plz help

Just getting started with the process. Have already had the seminar and have my first visit with my surgeon next week. What's the process like?

Anybody have experience with them for revisions from Lapband to Bypass?

does anyone know the policy and procedure to have approval to receive the sleeve surgery through them ?

I know that reading others posts helped me a lot so I wanted to post some info. I got approved by Anthem BCBS Ohio in 24 hours. My doc submitted 6 monthly diet forms along with my psych evaluation. My BMI is 43.

My paperwork is being sent off to Aetna tomorrow (yay!!!) but I do have a question or two Did you guys have to pay your deductible before you completed the surgery? I've done ALLLL the physician appts, nutritionist appts, x-rays etc and I haven't touched my deductible yet! These appts were copays only and counted towards my out of pocket max, but not my deductible.

Hi i have may choose metroplus as my HMO I have Medicaid . I was wondering if the 6 months diet it's required with metroplus Medicaid .

Hi. Just looking for some help from Anyone who has Humana or Medicare supplement insurance. I've had all my info faxed into the insurance as of Friday. I'm super impatient. Please someone help. Just waiting for call of approval or denial. Thanks. Will

Has anyone been approved for surgery with the insurance BCBS TX PPO insurance

How long did it take for approval or denied for BCBSTX?? Anyone plz =)

What should I do if I already now it's bot covered at all in my PPO insurance?

Hello anyone that can help me with some info =) so if I'd get denied how does the process work for out of pocket? Please and thank you in advance

Anyone had blue cross blue shield PPO and got approved

Any one done an appeal for cigna? Can I do the appeal myself or does my doctor have to do it? What all will I need to submit an appeal?

Hey folks. Just curious if any one can help me with how long it takes to hear a reply from Humana / Humana Gold after paperwork is faxed in from Surgeons office. !? I'm done with everything that's required so I'm just waiting for the answer from insurance company. I'm not a patient guy at all any advice would greatly help. Thanks

Hello everyone. I am new to the forums. I'm happy to meet you all! I have a question. I asked my insurance rep what it meant- but he said my actual insurance company was very "vague" in the term and he encouraged me to basically grab whatever info I could from my PCP regarding past weight-related visits, just to basically have the theme of "weight" documented past visits. The term I am referring to is, while my insurance does not require me to go on a 6 month diet or anything like that, it does say it requires "Documented failed medical weight loss history" I asked my insurance rep if that entails failed diets "created" by my doctor, or if it included weight-related…

Hello I'm new to the group my name is Esmeralda and I would love to get so tips or help on someone that went through the BCBS Texas insurance for this procedure.. I've called and they tell me it's not acceptable at all with PPO family insurance ????

I'm just beginning my journey and my first appointment is 6/29. All the ins stuff really confuses me! Does anyone have this type of insurance and know what "hoops" you have to go through?

Hi, I'm new here and I have read a few boards and I see everyone is beyond helpful in some way. I'm 25 years old and live in Westchester, NY. I went for my seminar December 10, 2014 And have my first appointment with the surgeon January 23☺️was wondering for those in NY with emblem health how long after your first appointment did you get a date? What are the pre surgical requirements that need to be completed beforehand? Thanks so much!!

How long did it take for UHC to approve your surgery??

Anyone have any experience w/this insurance company? Waiting for approval/denial.....

Does anyone in Wisconsin know. How the approval process works. If you have state insurance. I currently am covered under children's community health. But I was considering. Switching to BcBs or United Health.

Does any one have their insurance pay for their Protein drinks? I have seen an adveritsement on here about it. The site is insurenutrition.com if anyone else is interested.

I am so frustrated right now. I have been planning my surgery since last Oct and had my pre-op on July 17. On that date day I got my surgery date of Sept 2. On Aug 5 they submitted all my stuff for preauthorization and here I am Aug 26 1 week preop, halfway through the liquid diet. My insurance company hasn't made a decision and furthermore they had no idea when they would have an answer. I have taken the time off work and have to request time off 30 days in advance. I feel like I am totally screwed and all my carefully laid out plans are coming apart. Any suggestions?

Fighting a losing battle over insurance coverage. I was told one thing and billed completely different. I am in desperate need of anyone who would be willing to help me understand what they were billed, what was covered and what was not. I think they are pulling a fast one because we have Delta Health as our plan manager and they are both pointing fingers at each other. I need a baseline to see what is usual and customary for them to pay for the surgical supplies,operating room and overnight stay etc. If you want to do this privately please send me a fb message. https://www.facebook.com/shannon.vanhoosancannizzaro

So my information was sent to my insurance company, BCBS of Rhode Island, a week ago. They came back yesterday requesting more paperwork. Just wondering if anyone had any experience with BCBS of RI and if them requesting more paperwork was a good sign? Just nervous and hoping this works out....the waiting is brutal!

My procedure is scheduled for September 2nd and I've completed every appointment except for a second apointment with the nutritionist (that's scheduled for this Wednesday). The request for my authorization was denied. Then, the Peer to Peer was denied. So an appeal was filed on July 31. Just waiting for an answer. I hate that my surgery date is this close and I don't even know if it's going to happen. I had resigned myself to take it as a sign if the appeal came back denied that I would tell the surgeion's office not to file any more appeals (she said they can file 3 times). I've changed my mind as far as that's concerned. If they have to appeal 3 times and they're…

Does anyone have any experience through great west ?