Insurance & Financing

When your at the fifth month visit what happens now. I am finished all the medical. Wow, that was a lot of stress. When your over weight the thought of the test coming back wow a lot of stress. Now moving forward, what's next.

Hey all, I just submitted my paper work in to my new doctor, and we are waiting to hear what other pre op tests I need to do. Back in July I had Cobra insurance, and after going through all the pre op tests with a doctor in my town, I was denied. I have Aetna now, and am going to an in network hospital and doctor about an hour away. Did anyone else with Aetna have to pay a copay? My insurance is called Aetna open choice ppo if that helps at all. Either way, I can't wait to get sleeved!

I have bcbs texas insurance say i have to pay 30 percent of band device itself anyone know how much the band cost?

My insurance finally approved me after 6months! What a breath of fresh air

I started my journey in March 2012 and today I received my approval. I go next week to schedule my surgery, they told me that I am still maybe a month and a half away.... I am so anxious, ready to start my new life....

Today was my final weigh in & everything should have gone to insurance today! My CNRP that runs the program insists I should be an easy approval, BUT it will probably be at least Tuesday before I hear! I keep having palps that I will be denied. LOL Anyway.... thanks for all the support on this site!! I am so glad you know how I am really feeling!

Hi, I was wondering is their anyone that had Cigna (north Texas) and how long was the approval wait ? I completed everything that was asked of the insurance company and all paper work has been submitted. As you can imagine I am ready to get the procedure done. Anyone ? Thanks!

I'm getting so discouraged I really want this lap band surgery I'm 23 newly engaged and want children within the next five years. I have a very supportive fiancé who has been through my ups and downs and medical issues due to being so over weight ( have been my whole life) and don't think it's fair to my future husband and children to see me die from all the medical issues that come with 400+ lbs, but my sad reality is unless my insurance pays the majority I will be unable to have the surgery I have medical mutual anyone else?

I'm under my mothers insurance (1199) and we're in the beginning stages right now consulting doctors and such. I tried making an appointment with Dr.Goyal of NJ Bariatric Center in Hoboken, but they're waiting to see if my insurance covers everything. Does anyone know how long it may take to find out? Or should I just keep calling and be on their ass about it? Sometimes I feel like that's the only way to get things done.

For those of you that paid out of pocket or financed what was the wait time to get everything going as far as preparing for surgery? Sent from my iPad using LapBandTalk

I just wanted to share my story for all Wells Fargo people out there that may be struggling with approval or may not know the process. I made a few mistakes along the way, so hopefully you can read this and learn from it. I started in November by going to the True Results (AIGB) location in Austin, TX last November. At this time, I was on Wells Fargo's Cigna Health Plan and was at aproximately 37 BMI. True Results did an introduction and the usual first step things and scheduled me for a sleep study to determine whether I had sleep apnea or not because under Cigna and most plans, you have to have 2 co-morbidities if you are between 35-40 BMI. It was determined that …

I am double covered 2 bcbsal. My primary ins. Has a bariatric exclusion on it, but my secondary will cover wls. I tried to have the lap band in "09" and the ins. Lady there said I would have to drop my primary ins. In order for them to have my wls approved. I did that and ended up getting denied anyway ( thank God). My husband changed jobs so I was able to pick my ins. Back up and now getting ready to submit info to bcbs next months and not wanting anything to prolong my time I asked the ins lady at this office about it and she said I wouldn't have to drop my primary ins. They would submit to the primary and let them deny it and then file to the secondary ins. And they SH…

Ot without a hurdle or two... But I am approved for surgery and one night stay(?) anywho cant wait to get my date tomorrow!

Yay! Finally, I got a call from my doctor's coordinator and they sent it in and got disapproved and then they fixed something and after they sent it back in it was approved in about a week. Now I am waiting for the call to get my preop and surgery scheduled. They changed my doctor though because apparently Dr. Scarborough is out of network and Dr. Yu is in network so he will be doing the surgery.

SO! to my knowledge my packet was submitted to insurance last thursday. but nooo i received a phone call saying the NURSE had me down for lap band surgery and they didnt have the authorization code for GASTRIC SLEEVE! so i had to call the surgical sheduler today to clarify and they are going to get the correct authorization code and resubmit to insurance. i KNOW how wicked busy these people are. but you would think they would at least review notes and see that i made a final decision my last 2 visits? im not mad. just frustrated and anxious. to the point where im dreaming about this surgery at night and it keeps me up. (i blame Chantix for part of this as well) oh yeah t…

I was approved by Tricare last week and i have a Surgery date I am so excited I was scared I would be denied because I thought to myself they are not gonna approve mesince i didnt d the full six months of visit but they did and I'm so happy

What is the right amount of time to wait before calling your insurance company to see if you were approved or not? I just am soo excited I can't wait!

I was just wondering if it would be wrong of me to call HR asking about the additional 3000 co pay it has for biatric surgery. I have read other posts that other BCBS does not have that extra co pay. I'd like to know if they will still have that and or maybe ask if they can get rid of that extra....lol. Silly I know but I can not afford that. I do have plans or changing our plan policy to one that covers more with lower decductible and co pays, which means more deduction on my hubby's paycheck. As like everyone else we live on a budget and we can't do a extra loan. Any one have any thoughts or experiences with the same issue I am going through? Thanks, Teri

Help? I got questions if you carry insurance through healthlink!

So I live abroad and it is my responsiblity to pay for all outpatient care and then submit a claim through my insurance. So far I have completed blood work, cortisol screening, a ultra sound of my liver, pancreas and gall bladder, bone density scan, 1 psych eval, 1 NUT eval, endoscopy, a visit to the endocronoligist and more blood work, and paid for my initial surgery evaluation for a total billed amount of $1681.16. I have only paid $297.47 out of pocket. Most of the bills have come within a few dollars of the insurances plan allowances. I wonder if I was state side how much all this stuff would have cost? How much would the doctor bill vs. how much the insurance …

I am a 21yrs old and I have been struggling with my weight since I was in elementary. Since I was young enough to take medication for adhd I have. And in the 5th grade my mom took me off the medication. I was very skinny up until then. That summer I gained at least 50lbs. About 4 years ago I lost 90 lbs, but I did it in the worst way possible. I was 220lbs. I gained most of that back, of coarse. I am now 211 and I am thinking about getting the surgery done. I am not sure if my age has an effect on this or not. I really wish it didn't but I'm not sure. I have a bmi of 37.2 but no blood pressure or diabetes that I know of. I'm not sure when the last time I got checked was. …

Greetings, I have my date! October 18. But.... I don't have final approval from my insurance company. Kinda freaking out. First of all, my insurance company is very small and easy to work with. We have had it for 10 years- through my husbands employer. They have an outside approval company that has never denied anything... One hurdle, they only cover band and rny. They did say they will let me do vsg if it is a better option for me (pending approval of wls surgery from the outside source). I have had all of my tests done, my 3 month supervised diet and now all I need is a sleep study because they think I have apnea. I'm not super concerned that I won't be …

Does anyone know if aetna will accept weight watchers logs for medically supervised diet with a letter from PCP? Or what other diets the insurence may accept? do they ask for the records or will a letter from my pcp with details work? like dates and weights because the DR;s office notes leave alot to be desired....

I have talked to my insurence at least 15 times to confirm coverage and reviewed my plan discription. I had a feeling that the insurence would have more then just a BMI requirement that they had been telling me and my plan discription stated. So i wrote the insurence company and got this reply.... Dear Mrs. Austin; We are in receipt of your request regarding Lapband Surgery 43770 and what information is needed to review for a predetermination. The folowing information would be needed from the surgeon; * A Letter of Medical Necessity(LOMN) with height, weight, BMI, comorbidities, medications used to treat the co-morbid conditions, documentation of a 6 month(180 day…

Hello! I am new here (1st post) and will be going in for my 6th month appt next week, only to find out that bcbs took that requirement away? I did lose about 18lbs so I guess thats a good thing? I have an H M O so I need a referral to a bariatric surgeon from my PCP. I've seen a nutritionist already, in my 1-2 months. Is there anyone that might know the timeframe in which I can get in to see a surgeon and also what else i have to do?My insurance will most likely change by November, (relocatuon out of state) so I was hoping to get the surgery done by then... PleaseAdvise!

Does anyone know wthat insurance covers lap band surgery? I'm thinking about getting it because its my only option at this point

So, I went to my consultation yesterday and it was great. I was given the three options for WLS and I was still happy with the sleeve and the surgeon was as well. I talked to the "insurance guru" at the hospital was very pleased with the requirements. So far what I understand is you have to have a BMI of 35 with two comorbidities or a BMI of 40. My BMI yesterday was 50 ... I have hypertension as well. A psych evaluation, and three months of supervised dieting and meetings with a dietitian. My surgeon also ordered blood work and an EDG. So far so good I guess. Financial costs: Seminar- free Consultation-50.00 Phych eval, dietician appointments, Protein mix and…

My insurance won't pay so out of pocket will be about 13k. It's going to be very hard to convince my hubby to let me finance this because he already believe I should lose weight the old fashioned way. Any suggestions on how to get insurance to pay? I wanted to lose a min of 50 lbs and a max of 70 lbs. some may thinks that's not enough for surgery but I have a fat person living in the inside so I'm always on the weight roller coaster.

Am going into month 4 of my 6 month supervised diet, and I'm not losing any weight. In fact, I gained 4 pounds in month 3 and have not been able to take it off. I do have a letter from my PCP that states that I have trouble losing weight due to my thyroid not being regulated yet. But since they tell you during the 6 month diet not to gain, I am worried that this will just ruin it for me. I have upmc for you... Which is a Medicaid ins here in Pittsburgh. My bmi is 40 with asthma and back issues. I need this and I am so worried. Any help is appreciated.

Approved within 5 days!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!Thanks you BCBS!

What does pended mean?????? I looked up my refferal online and that's what it says

Hi everyone, I am new to this site. I am currently 243 pounds and I am 5'5 1/2 feet tall. I decided on lapband surgery as the next step in my weight loss journey. I am an RN and currently qualcare. My surgery is eligible is covered at 100 percent. Also, according to the insurance coordinator at my surgeons office my insurance is the Easiest to receive approval for!!! So I did all the pre-op testing (Bloodwork, venous Doppler, psy eval).. So I am asking for some good luck to Be sent my way.... I should find out this week !!!

I received my explanation of benefits in the mail today. The hospital billed my insurance $54,000.. That's a 2012 BMW M3 luckily I only had to pay $500 insurance, handled the rest.

Hey all, submitted all my paperwork to the insurance company today! I have bcbs of Illinois how long do you think it will take to hear something? I am sooo excited!

So today I called my insurance again, to get a better understanding of the process. So far pretty much all they can tell me and all that I know is That the person doing the surgery calls and gets the authorization. That is all they can tell me... So it is just a wait and see until the seminar what the doctor does and what all I will have to do.... Thanks to this site and some videos I have decided that I need this surgery and I will do whatever it takes to be successful after it... I will use the tool to my advantage I will be so happy to control my hunger that much more... Cant wait...

I was planning on introducing myself.... and so happy to tell everyone that my surgery date is set for Oct 8. I have done the six month supervised diet,all the preop tests everything that was required. I came home tonight and received a letter from Cigna stating at this time they do not feel there is medical necessity for this surgery and that I should send more documentation to support the necessity. I am 275 lbs 5'3,my BMI is 50 ....Really...my knees hurt,Im tired all the time,my back,feet hurt etc and oh yeah I want to live longer,be healthier,see my kids grow..Im so ready in every sense of the word for this.I have a bad feeling.I do not have diabetes or high blood pre…

I'm APPROVED!!!!!!!!! I am so happy. All it took was 3 days. I wasn't sure if I was going to get it because I did not have a BMI of 40 for 5 years, which my insurance required, but I gave them what I had and more and they approved me! Happy Dance!

Well let me start from the. Begining... I am 22 yrs old and I weight 230 lbs I am 5'4... I have chronic back pain it's so bad Ihaven't. Been able to walk all week because my back hurts so much drs have no clue what I have and he said that the best way to get rid of the paint is to lose the weight!.,.. I already went to my surgeons consult and he said he could do the surgery by the end of sep.... But tricare is making me do the 6 month diet with my dr... Now to my question... Do any of u know I tricare would make an exception to the 6 month diet if it's urgent? Like if my dr writes them a letter explaining my situation.. I'm so tired of being in pain and I don't know ho…

I called BCBS federal and was told yes, the sleeve is covered. Now my surgeon's office says it isn't covered and I have to go with the bypass. I don't want the bypass---I think the sleeve is a better solution for me. Anyone have sleeve covered with BCBS federal ins?

I recieved my letter with all my preop appointments in the mail Saturday evening. They changed my Date to 09/25/12 ... my first lab appointment is 09/11, I also find out about my preop diet then, and my class is 09/13... At one times it seemsed like everything was dragging... now I feel like it's all down hill ... I'm excited and a bit nervous.

Has anyone that has UHC not have to do the 6 months diet thing?

I have cigna as my insurance i have a bmi 40.2 but i dont have diabetes or high blood pressure do u think i will be able to qualify with my insurance??

Does anyone know how much The surgery cost?

Who else is in NY waiting on Medicare to presuthorize? I was all happy because I'd heard that Medicare eas approving in NY on a case by case basis. While I know I am a good candidate for this surgery and have.a goid chance of being approved the not knowing for sure if &when it will be pre-authorized has me feeling a bit frustrated. I will see the surgeon on Friday. I have all my paperwork in since last month. One document I needed is ready to hand in when I see her Friday. So in all it's been over a 7 month wait of this process. I'm so ready to have it done.

I have oxford *** waiting on my approval they said 2 business days

I am starting, (again), my 3 month process for Aetna with VCU Medical Center here in Richmond. For some reason, the insurance coordinator for my surgeon does not have a wealth of information. For those of you that have been approved by Aetna on the 3 month process, how did your process go from start to finish? As i explained to the insurance coordinator, I want to have all my ducks in a row the FIRST time I submit my information to show that I am really putting forth the effort and that it would not be a waste of time of money to allow me to have the surgery. I became soooo frustrated at work today and even briefly gave up.. For those of you who have Aetna and call t…

Applying for medicaid and hoping and praying that I can get sleeved with it....

SO I have called my insurance company and they said that the lap band is only covered if it is medically necessary. and they need to have a doctor call them for authorization. Why does insurance have to be such a pain... I don't see why it wouldnt be necessary on my part I am kinda jacked LOL.... BMI 46 sleep Apnea Depression Family history both sides of Diabetes (on the edge) So now what? I am going to a siminar the 15th of this month.. What happens next.

Does anyone have this insurance? They do not cover the sleeve for me, I was wondering if anyone has this, If so I'd like to know if you fought and tried to get them to cover the sleeve? I would hate to follow through with all my visits only to be denied. They do cover the gastric bypass but I don't want my insides moved around. Any thoughts or advice?? Thank you, Teri

Once I decided to have WLS I contacted a local bariatric surgeon and I signed up for a free seminar. I initially was interested in the LapBand but after the seminar felt that the sleeve would be the best option for me. After the seminar if your were really interested you felt out the patient paperwork and they said they would contact us two weeks later. The time seemed to be passing slow so on Friday (6 days after seminar) I contacted BCBS and was just asking some general questions about WLS and the representative was a bit rude and really had me thinking it was a no go. The next day exactly one week after the seminar I receive a call from the surgeons office and th…