Insurance & Financing

I have a rant! I have a co-worker that's constantly complaining, says off the wall comments to me. Likes to be a drama queen per say. Yesterday at work we had a confrontation, which she started. My surgery is the 28. I don't want to lose my job, but I want so bad to read her loud annoying a$$. She belittled me right in front of my co-workers. I bet she feels like I'm her puppet. Now would you handle her in a professional way? Lord please give me strength!

I have highmark blue cross blue shield and and doing my 6 months diet training. This is my 3rd weigh in but my 4th month. My surgery is scheduled for Dec 19th. And from march to July I lost 25 lbs but that was before my six months started. From July to Augi lost 9 and Aug to Sept was 4. Today is my next appointment but I think I either stayed the same or maybe gained a pound. My question is could my insurance deny my surgery if I didn't lose this month?

Does anyone know what exactly qualifies a person for covered tummy tuck surgery after significant weightloss?

Hi all -- I just started with a new company and I have two options for insurance... UHC Choice Plus or Aetna Choice POS II. My summary of benefits for both say: Other Covered Services: Bariatric surgery. I'm trying to decide between the two and I'm hoping you all can help. I would like to have the Lap Band Surgery. My BMI is over 40. If anyone can share which one they had good luck with, I would appreciate it. Thanks in advance for your help!

I was approved today and set a date of December 19th! I had lost a little faith because it took forever to get my medical records. I was approved on the first try by Health Alliance in Central, IL. I couldn't be more excited to start this new chapter!

Hello, I am interested in getting the gastric sleeve and i was wondering if CHIP covers the surgery. I was recently approved for CHIP also. Im in Houston, Texas and 18 yrs old. Thanks! :D

27 days after my surgeon submitted my paperwork and clearances, I got the call today that I've been approved! The next call I receive will be from the surgical scheduler with some possible dates! I am so excited!! For Michigan Straight Medicaid, I had to have an echo, EKG, stress test, chest xray, A1C labs, other blood labs, and a psych consult. No 3-6 month medical diet. I'm 5'9 and my BMI is 45. I have HBP, I'm pre-diabetic, I have arthritis in my hips, knees, ankles and neck, venous insufficiency of the lower extremities, stress incontinence, and random rashes. I've had estrogen-positive breast cancer, which let to a complete hysterectomy. My thyroid function is per…

I'm new here and just needed to vent a little I guess. I am going to ve self pay for vsg. This could be a little long. A little back ground on my story. My grandparents told me a few months ago they would pay for plastics if I list all my weight. After alot of research and thought, I approached them with allowing me to gave vsg instead. I have already met with my surgeon and have been approved for surgery. Now I am just waiting for my grandparents to give me the go ahead. I have about 160 to lose and am so ready to start this journey. Yes, I am even excited to start the pre op diet. This waiting game is about to destroy me. I can't sleep at night. I lay…

Did your insurance pay for these? i will need 10 40mg injections. Thanks,

Apparently my insurance company denied it, saying that the surgery wasn't covered. My the surgery center says it is and that they have a reference number or something from when they talked to them the first time! They said not to freak out and they have already filed an appeal. I guess it has something to do with codes and it being weight loss vs medical necessity? Idk, but very frustrating!! Especially since I've already been jumping through their hoops for 6 months now!

Got my surgery date today... 10/22. Aetna is awesome and approved me 2 weeks after submission so it's all downhill from here! I'd love to read about more of your stories so if you're blogging your journey, please reply with your web address!! I'd love to share experiences with you! My blog is at: Www.blondeandbanded.blogspot.com

So, nearly three weeks ago my surgeon's office submitted my paperwork to the insurance company for approval. I waited two weeks and had still heard nothing from either so I called the insurance company to be told the nurse had not even looked at my submission yet, arg! Yesterday, Saturday, I received an automated call from the insurance company asking yes or no questions about my upcoming scheduled hospital stay. It asked if I had discussed my procedure with my PCP and if I had someone at home to assist me afterwards, and other questions like that. I sent an e-mail to the doctors office hoping to get a reply tomorrow. I'm excited but afraid to get too excited until I…

Hen surgeons submit files to the insurance do they say it's a "bariatric surgery" or sleeve gastric????

Just got the call that I have been approved by my insurance company. Originally they had said that I was going to need to do six months of supervised weight loss to get approved, but they approved me after 2-1/2 or 3 months (forget the exact date we started). I've given them a set of dates that fits into my work schedule, and I should hopefully have my date later today or tomorrow. The only bummer is that my wife hasn't been approved yet. The insurance coordinator at our surgeons office is still working on her case and said that it may be one of those situations where one spouse is approved early and the other has to do the full six months (sounds odd to me but she s…

Just met w/ my PCP who is well aware of my struggles. He said he would try to compose something acceptable to show medical supervision that will satisfy their 3 month medically supervised criteria. Am cautiously hopeful....

Does anyone have this ins ??

Does horizon allow you to add a brother or sister in the insurance under the age of 26????????????

I have only been working with my weight loss clinic. I have not talked to my insurance, should I be contacting them?? Telling them what I'm doing?? I'm just confused, wls clinic says we take care of everything. I'm not getting warm fuzzing feeling with reading the posts on here. Please if you have any suggestion!!!

So I had my insurance turned in last Thursday. I called today and they said it could take three weeks for an answer and then I will schedule an all day appointment with a class and labs and such. That is when I will receive my surgery date. That is all if I get approved at all. I am on tri west which just was taken over by united healthcare, they say I'm good to go but my doc office says I don't have enough diet documentation. This is so frustrating.

Is there anyway to get around the insurance companies medically supervised diet for the last 3 yrs. I was on a medically supervised diet in 1998 but am told that's too old. For the last 5 yrs. (once a year) I've been on a medically supervised HCG injections diet but am told that won't work because it's pharmaceutical. In between then and now (like most of us) I've been on a million different diets (eg. WW, Jenny Craig, L.A. Weight Loss,etc, etc. ad nauseum) ahhhh- what can I do. So frustrated!

I'm starting to research how to fund my surgery as I don't have insurance. I want to make the best decision to avoid drama and additional charges. Has anyone had experience with financing through; fundmydr.com, creditcare.com or unitedmedical.com? I have read good and bad reviews on all three, and I don't want to apply here, there, and everwhere as credit checks lower your score. Any recommendations? Thanks!

My insurance requires I have 6 consecutive visits with my family physician to be weighed every month. I am current weighing under 2-3pounds weight difference. Just those couple of pounds can make ineligible for the surgery. Today I am bloated and I weigh perfect weight for surgery. I have to for 6 straight months of being weighed. If I lose one pound it kicks me out. Do you have any suggestions on what I can do? Thank you, Jennifer

Decided on the Sleeve for many reasons even though it's more invasive than I wanted but in the end much less hassle than the band. My real question here is about my Cigna insurance. They require a 3 mo. Medically supervised diet and my PCP is gone all week so I won't get started till next week. It's important to get this done before the new insurance year (think it will be more difficult after Jan 1). Does anyone know anyway around this requirement? Or, any language more acceptable to the insurance company that I can suggest my PCP uses? How can I shorten the time frame from 3 months to two?

I have BCBS OFRI my Dr told me 6 months of a supervised diet I had to have. Monday she calls me and says were submitted it ti insurance ... I was shocked. I have had 4 visits. She says its becuase for the past year when I say my regular DR. We spoke on diet and exercise and it was dicumented just nervous. If in denied ill be so upset. and now im laid off and paying for COBRA 689.00 a month. Its fine I don't need lights or heat or gas in the car. (Sigh)

Looks like many folks in some states may not have bariatric coverage. Much of this won't go into effect for 6 months so now is the time to git er done? Looks like the ACO's(accountable care organizations) will have the oversight to determine medical necessity per state? http://www.bariatricnews.net/?q=news/111009/obamacare-denying-patients-access-bariatric-surgery

For anyone that has already had surgery and you have BCBS Federal- Basic, did you have to pay for 30% of the drugs/agents (anesthetics) that were given to you during your surgery or the medications that were given to you while you were in the hospital? I'm getting conflicting information. I was told by the insurance company that anesthesia is covered 100% but I'm responsible for 30% of the drugs or agents used during my surgery. Thanks in advance for your feedback.

I was wondering why Medicare makes you wait six months for the surgery.

Does anyone know how the long approval process of bcbs il with a ppo is? Is there extra criteria?

I'm approved.

So I have insurance from my school which pretty much is like any other insurance cards... Now did anyone get their approval? How long did you wait? What are their requirements ? I am afraid because I'm only 200 an my BMI is 34.5 I think?! But I do have problem getting swollen and break outs ... Please help

Well I started my sleeve process in the beginning of this month , I currently only have one more appointment left before I can have my results visit and submitted to my insurance. I was wondering about how long does it take for BCBS TX to approve. I'm actually very nervous about that part, right along with this pre-op liquid diet !!

Can anyone recommend a lending company for medical loans? For NJ? Some with not so great credit? Please let me know

Since I was a teenager I have had a BMI between 35 and 39 with a few good weight loss runs that put me below and a few pregnancies that put me over. I have no co-morbities but my Mom died at 49 and my Dad died at 51 from obesity related issues. I am 36. This past year I have hovered between 40 and 41. Last year 2012, I was pregnant and my only weigh ins were while pregnant and my post partum visit weigh in I only gained 25 lbs (1) can I use any of those weigh ins to count? (2) my BMI was only 38 still morbidly obese but not above 40. In 2011 while I do have non-pregnancy weights my BMI was still only around 38. Has any one used pregnancy weights (first visit or post…

I just received a notice that my employer is changing to United Healthcare from BCBS effective 1/1/14. I'm super pissed about that. However, I want to know if my fills will be covered by UH. I'm getting really worried because I'm having trouble finding my doctor that does my fills in the "in-network" database. Has anyone ever had to go through this? Should I just call my doctor to see if they accept UH? With BCBS, I didn't have to pay any copays. Does anyone with UH have to pay copays? Any help and guidance would be greatly appreciated.

My insurance company just acknowledged the receipt of my application. They told me I'll have an answer on whether or not I've been approved in 5 working days. It's going to be the longest 5 days ever!

Anyone have this insurance?? Just wondering what the approval process was like. I am in the process of gathering all required documentation and just wanted to know people's experience with them. I haven't come across many people who had this insurance.

I'm getting very nervous as the time to submit draws closer. Wednesday I have my last visit which includes the liver class. My bmi is 36 with Co morbid of high blood pressure diagnosised in June this year, gerd, and rem sleep apnea. Did anyone not have to submit pass weight history for BCBS? I'm on the state employees plan and they offer an awesome contract. What was your bmi& comorbids?

Does anyone have WV bcbs? I was just curious on how long it took to get approved and what all everyone had to do. Thanks

Has anybody been approved since they changed their documentation requirements on the 10th? If so, was your documentation consecutive? I have 6 months of documentation but it's spread out over 15 months...

Started my process of wls in August 2013. In June of 2013 I was working with my Pcp with weightloss till Aug and she suggested the surgery. My insurance requires 6 months of supervised diet. Well, thought about the other day way should my pcp visit count? Called the weightloss clinic they said NO it all has to be here. Called my insurance they said absolutely it counts. What do you think??? I go back to my nut on Oct.7th talk about it then.

Some have asked about out of pocket costs. I'm 2 mos out and I think everything is in. 3 nights in hospital, and surgery. Pre op testing, I think my out if pocket is right around $850. Seems lower than I thought it would be, hopefully nothing else pops up.

I was submitted to BCBS of IL yesterday morning! I called this morning to verify they received it, but how long does it normally take for people to hear back?? I'm trying to push the place I'm having the surgery at to schedule me ASAP so I can have it done this summer! So excited to get this process going. So nervous ill get denied though :-(

Has anyone been approved for VSG with a BMI below 50 and not as a part of a 2 part procedure through Independence Blue Cross of PA Personal Choice? I'm confused what they approve and don't approve. I'm just starting my journey, I have my first appointment with the surgeon in 2 weeks and would really like VSG. Thanks!

Has anyone gotten an approval from UMR without the 6 month diet requirement?

Having my first appointment this Tuesday...BMI of 40 with sleep apnea...I have BCBS of IL through my dads work which i believe is PPO.... I am really concerned about approval...I have read several threads and nothing is consistent....surgeons office said they no longer require six month supervised diet which i am postivs of but do they require a letter of medical necessity and weight history!? I have three years weight history about 35 but I moved to North Carolina And I cannot manage to get a hold of my medical records from my previous doctor. Any advice???

f**k this **** I give the f**k up I've tried a year straight and I don't have the f**king money to go to weight watchers for a year it's f**king bull **** I've f**king wasted so much time I was happier before I wanted this surgery

Requirements? Was it hard to be approved? Was it jumping thru hurdles? Just got em and wanting to know.

Hi I Am new and very nervus about my surgey,any advise!

A lot of people always want to kno what health insurance don't require 6 months weigh in well I know for sure metro plus required no weigh ins at all as long as your doctor approves of you getting surgery your fine!!! I took only 3 months to get my surgery date and approval I'm scheduled for oct 1

Hey all, I'm new to the board! I just have a question about whether any of you who had to do the 6 month supervised diet were able to do Weight Watchers online along with going in for visits with their physician? I'm worried that my insurance will think that the online version isn't enough, but I plan on going to my doctor every month and being weighed by him as well as documenting everything. I tried getting in touch with my case manager, but she was unavailable. I suppose I am just wondering because I'm so ready to get started on this journey that I want to know which one to sign up for, so that I can do it today hahaha! Thanks! - Mia