Insurance & Financing

Ok don't laugh how do u respond to threads..lol.. I don't see a button to respond..please help..

Hello everyone, I've decided to have the gastric sleeve, my first consultant was August 22, after talking with the surgeon these are my requirement: blood work,psych eval, one visit with a dietitian,online teaching class, I ask the surgeon how will I know if I'm approved, he said that I will be approve, and I'm thinking WOW so where do I go from here?????? Well I had my blood work done the same day,,, my 2nd visit with my surgeon is Sept 18,,,my guess will be that he will be ready to schedule my surgery???? ~N£wLif£NewM£~

If you cash pay the surgery can you still get the irs deduction if you have the sleeve done outside the u.s.??

Hi everyone! Completely new here! I just wanted to know if anyone else was having a hard time getting the letter of necessity from their pcp? I have United health care and I asked the surgeons office to submit the insurance packet without it (doing that today keep your fingers crossed) but I wanted to know if anyone else has had issues getting the letter and if there's a chance for approval without it?

I have bc/bs of Minnesota and after an initial denial letter wanting more dietician visits, more psych visits and 2 yr history of high bmi, my surgeon and I submitted an appeal letter each and it took the full month but received the approval letter today. They deemed a revision surgery as "medically necessary". I'm over the moon excited! There is hope people!

Choosing Insurance plans is like choosing between syphilis and gonorrhea. They all stink !! With my insurance I was caught between a rock and a hard place. I didn't have enough co-morbidities, they require documentation of a 6 month diet, and I wasn't employed by the hospital for 24 consecutive months (another ridiculous requirement). Had I lost 20 pounds, my BMI would have been too low..... so I'm off to Mexico and paying cash.. HealthChoice and Orlando Health can just kiss my big fat healthy Butt. Having to wait another year and gain more weight would have made me a higher surgical risk. I guess they would have preferred I'd have had high cholesterol, diabetes, high…

I am at the very beginning of my journey I just met with the surgeon and my first nutrition class is the end of august. I was told alot of people with EHP insurance are getting denied for the littles things? Help ??? any suggestions or your experience with EHP?

Took the dietician classes for 4 months, saw the shrink and got approved the first day insurance received my paperwork. BMI - 37 but have High Blood Pressure (take 2 pills not the req 3) and Metformin for pre-diabetes. Can't believe there was no trouble with my insurance! Yay

Hi everyone, So I wanted to share my story so I could maybe get some insight from people who have gone through the same thing I am going through. I originally had a BMI of 36.4 and thought that arthritis was one of the co-morbid conditions which Oxford insurance would cover, but it was not, and I got denied. Now, I am allowed to appeal, but my weight has definitely increased, so my BMI is higher. If I was to have a BMI of 40 at this point (which I am very close to), do you think they will cover the surgery now that I am heavier and at 40 BMI? Do I have to appeal with a new weight? Or do I just resubmit all my papers to insurance with the new weight/BMI? Has anyone…

I finished up my 6 month diet yesterday and the insurance coordinator said they will submit today. This is the second time because the first time I tried to use my weight watchers weights but they denied it so I finished up my supervised diet and am hoping or a quick approval! They have 30 days to reply but I am so hoping it doesn't take that long! Anyone else have experience with bcbs of al? I'm actually in Ky. but they chose to go with AL. Any way to speed up the process or a way to find out if I am approved before they send the letter? Thanks

Anyone know if it covers bariatric?

I had my sleep study last night and their pretty sure I don't qualify for apnea. Only thing left in my corner is the fact my bmi is 36. Newly diagnosis of hb pressure in June, pcos, gerd, and fibromyalga. Has anyone had success with insurance paying for surgery? If you were in my situation, how long did it take? I have BCBS Florida employees group. Thanks .. signed frustrated!

Anyone with highnark bc vs? How strict are they about 2 yr history? The insurance policy reads 2 yr history of severe obesity. My bmi is just now 40. Last five years its been in the 35-39.5 range. Anyone have a similar experience with this? And I have no çomorbidities

I am just going into year two of my aftercare package which is covered for fils . At the end of this I will have to pay , any ideas ?

Still in shock that I was approved in less than 2 days with BCBS *** Blue Option with a BMI of 35.6 and comorbids of asthma and hypertension...Im so excited! Surgery is on Sept. 26th....less than 4 months after my first appointment! http://vsg2013.wordpress.com/

I have a BMI of almost 35 and continue to gain weight, despite my brief successes, it is just a matter of time until I put back on anything I might lose. Has anyone else worked with BCBS fed? Any tips or advice?

This is my first time posting on the site but I snoop around every once in a while and everyone seems to be knowledgeable about the sleeve and it's process. Here goes...... I currently have a lapband (placed May 2009) and lately I have had extremely bad pain when eating and occasional vomiting. I am no longer a patient of the doctor that placed the band so I had to find another surgeon. I saw him two months ago and he checked the band to see if there was a slippage and he didn't see one. He unfilled the band to see if I would get some relief and I have not (mentioned this to him). We agreed to do a revision to the sleeve with no further testing on the band to see if …

ive been trying to get wls sense i was 19 and ive been thru the process over and over now im self pay everything is taken care of besides the hospital stay and i may need to come up with 6000 before i can move forward with surgery does anyone know where i can get help for paying for the rest of the hospital stay if anyone can help please let me know

I am so excited approved by Aetna within 48 hrs. I was surprised they approved so quickly.

I am in California and have United Healthcare insurance through work. I believe I called and asked them if they cover any WLS an they said no. The Dr I have my consultation with this week said they take that insurance and most patients are covered. Does anyone else have united health and was covered? Or has anyone been told they aren't covered but when the dr submitted the info they were covered?

Hi all.. Im confused and frustrated. I have a primary and a secondary insurance. First I was told that neither required the medically supervised diet, so I thought I was good to go... I thought I'd be having surgery in a couple of months. Now another insurance rep for my primary is saying that I DO need to do a 6 month supervised diet. Does anyone know if I can just use my secondary insurance so I can have surgery soon.

Ugh! I thought I was done!!! So my coordinator emails me today that they gave submitted to insurance and insurance requires 5 year weight history from docs or we can provide photos with max weight that year. Tough to find since I don't like being photographed when I'm fat!! I think I've got all the years covered but dang! I wasn't a 40 BMI until this year, but I have been obese for over 5 years. I hope they approve anyway!!

Hello, I have BCBS-TX, I have my approval where they will pay 80% of the surgery and I will pay my 20%. I was told that the doctor and the hospital are two separate bills. Will not be hearing from them until the end of the week to know my exact cost. Was just curious did anyone else go through this surgery with BCBS-TX and about how much did you have to pay out of pocket. Would greatly appreciate any information! Thanks!

Now for my last class and to get my date....super excited!!! And approval took only about a week!!

I called BCBS and I was given my insurance approval and authorization code today. It was submitted on Tuesday. Thank God, YES YES YES!!!!!

What are some of the things I need to be prepared for during my visit tomorrow? Questions asked????

..is it a hard fast no always? I called and asked my insurance about medical weight loss/WLS surgery and the agent basically read off a script and said it's not covered. So I asked well, what if I have a letter of medical necessity from my doctor? To which she simply re-read the script *sigh* So does no really mean no or does this mean I have to look at jumping through a bunch of hoops? I'm hoping for jumping through hoops. :-) Before I found this info out, I made an appointment for a seminar on 8/19 with my surgeon of choice and one of the things that was mentioned when I made the appt I that I need to bring my insurance card with me. Apparently their insurance c…

&& im super worried that my insurance will deny me. I have medicaid with a bmi of 39. I know i dont have diabetes and hypertension. I can only pray I have some sort of sleep apnea or hypercholestrol to get approved. I need this so bad.

Anyone know of medicare is paying/covering the sleeve yet in Texas?

I just came back from the Doctor she said my BMI is at 39.7. Do I have to exactly be at 40 in order to get the surgery? Im not sure I have 2 comorbidities so I wont qualify. She said she could just put me at 40 if need be but if my paperwork sats 39.7 insurance will reject it, correct

I just called the insurance (BCBSofAL) and was told I am approved!!!!! I'm so excited! It was mailed and received on July 18th and approved yesterday!!!!

Anyone else in the 6 month class journey for approval??

Does anyone have healthfirst insurance and know how it works pertaining to bariatric surgery

Hi I m a state employer of MI and have Bluecare Network through Bluecross does anyone know will they pay for this procedure and did anyone have to jump through hoops for this? Thank you.

Well, I am on my way to getting my surgery. I have my first consultation on the 29th of August with my surgeon (I am excited). So I contacted my insurance company today and they told me that I needed a form from my doctor stating that it is medically necessary for me to get the surgery. But here is the kicker, I was told by the represenative I spoke with that the documentation can be filled out by my endocrinologist. This sounds a little weird because it seems like everyone else needs it from their primary doctor. Should I get both just to cover my bases? It will be hard to get in to see the primary doctor (my old doc moved so now I have to go to another). Thanks for …

Hey all. I was wondering does anyone have united health care? (Neighborhood health plan) and if so were they covered with no health issues just a very high bmi?

What were some of the recommendations your PCP put in your letter that was helpful getting you approved for surgery?

I got another $300 medical bill in the mail at my old address. I just happened to talk to the new resident, who said "hey I got some mail for you from a long time ago". Really? It claims to be part of my procedure, however it's not from the hospital and the company seems to be a scam. They claim my insurance paid most of it, but my insurance hasn't heard of these people. Anyone else experience this? Here's why I think it's a scam: 1) The company's finance department is ONLY open on weekends 2) Their answering machine sounds like someone's kid did the recording 3) Even though it's from 2.5 years ago, it doesn't appear on my credit record, yet was due 7 months a…

Hi! I just wanted to remind everyone that it depends on your employer. For example, two people can have united health care, but have totally different plans, even if its in the sae state, etc. is your employer self insured? ( they just pay uhc to administer the plan)? That makes a difference. If your employer provides you with a benefits advocate ( growing in popularity) that person can be very helpful Also, ask your employer ( or spouses if covered through spouse) for a copy ( electronic copy preferably ) of the SPD ( summary plan description) of your particular plan. That way, you can find the requirements yourself and use segments from the SPD should an appe…

I have untied health care and they pay some of the coverage but not all of it. I guess I have to meet my deb and pay 80%. Does anyone know if we have to pay up front?

Hi I'm currently in the process of my 3 month diet and surgery planning process. Would like some feedback if you were approved through BCBS FL state employee plan. I have a BMI of 35.5 with 1 known co-morbidity which is High Blood Pressure. I take my sleep study on Monday in which the doctor automatically scheduled me for 2 studies. Another one will follow in 2 weeks. I have PSOS,GERD, and fibromyalgia......BCBS FL only requires a 3 month diet and planning process.? So I've been told by my coordinator. She also said they don't require you to submit a 3 year weight history. Anyone here experience this???? I do have to say that BCBS state employee insurance is the Cadill…

So UMR is asking for 3 years of being morbidly obese.... Has anyone had this and how do you submit that history to them?

I have insurance through work, and our enrollment period is in November, so I can't make any changes until then. However, would it be possible for me to get insurance through another company right now and then just stay with them and get my surgery and then in November cancel the insurance I have through my work? Does anyone know if this is possible? I've been trying to research this online and all the results I'm getting are about switching car insurance, even though I'm specifying health insurance. Thanks!!!

Does/has anyone else had to do a 6 month diet before insurance will pay for you to have the surgery?

I am uninsured, so I will be self-paying, but my question is, are there any insurances that I could buy that would wind up costing me less than the surgery would cost me?

I have BCBS cover Tn ins and I was wondering if anyone has this type of insurance and got approved for the gastric sleeve surgery?

Anyone know of any places that take Anthem Insurance but does not require a 3-6 month waiting period? Originally the place I was going said 3 months and now it's 6 months and I found out today that my insurance does not require any certain length of time, there is a check list and I meet all the criteria!!! I'm from Indiana but would travel to get it done sooner! I so desperate I was looking into self pay options! Lol

Got my approval letter on Friday!!! Such a great sight!! I looked at when I saw the surgeon on the 5th and the letter dated on the 15th.. 10 days felt like an eternity!!!!! Going in a scrapbook. [ATTACH]15739[/ATTACH]

Hello I am new and i wanted to know if someone has UHC Community Plan and the requirements and how long does it take with no time limit so we going for 3 months supervised diet?

I think I may have found my doctor!!! If anyone can tell me any information I would greatly appreciate it!