Insurance & Financing

My surgery is tomorrow and my insurance says that authorization is still pending. I haven't had anything solid to eat since last week. Dr. Wants me to take citroma to cleanse my bowels, does this make sense? What if I'm not approved. I think the hospital should have been sent in my forms for approval. So frustrated.

Hi everyone. I just started exploring the Lapband and had made the decision to go for it. I inquired with my insurance company and tis is the response I got back: "Your plan specifically excludes : Weight Control Services including any Service to lose, gain, or maintain weight regardless of the reason for the Service or whether the Service is part of a treatment plan for a Condition." I am employed full time and pay extra to have a better BCBS plan so I am very discoraged with this response. I am 61 years old, weigh 280, take meds for high blood pressure, take meds for Type 2 Diabetes, and both of my knees are extremely painful. I know my primary care physician as wel…

Got the call saying my plan has an exclusion for bariatric anything. They can't fight it either. I need some help. Ideas.

I haven't has the surgery yet. I have kaiser and will be attending the options program orientation next week... I am eager to start the process and don't know what kind of a time frame I am looking at. Its been nice going through and finding people sharing the same experience! Good luck to all on here

Hello all! I've been lurking here for a few weeks. I originally had planned for the sleeve until further research and information from the my surgeon. I have GERD and was told that could get worse with the sleeve. ouch.. no thanks! My insurance required the 6 month diet, I'm almost done with. My 6 month visit is scheduled Sept 4th. Next week I have an upper gi with my surgeon. I originally started with a different surgeon until they informed my they weren't going to be providers of my insurance... long story. so I had already completed a nut. appt and pysc scam. BUT that surgeon had my height as 5'1, and my new surgeon has me at 5'2. My starting weight and height …

I had my last appt Thursday the 9th. My surgeon advised me to call the coordinator on Monday. She said she was still waiting on a letter from my PCP and my last appointment. I advised her of the date of the appointment, she said it would be a few days to get the paperwork in. Called my PCP they said they sent the letter on the 8th... they called her and left a message. I also called the coordinator and left a message asking for a call if she needed anything else. As of today no one has heard from her. I'm hoping this is a good sign. The wait is driving me crazy.

Hi all. I am going a seminar with Sharp in San Diego this coming Wednesday (which is one of the surgery pre-approval requirements). If I end up having the surgery, it will be with Dr. George Mueller. I have heard great things about him so far, and his VST profile says he accepts my insurance. I was wondering if anyone else has gotten approved with Anthem Blue Cross of California -- I have an ***, but there is surprisingly very little information on my insurance card. Also, if you went through Anthem, did you have to do the six months of supervised dieting? Wondering if my weight watchers tracker will count or if I have to start 6 months over again...

How long did it take to get your approval? If you were denied, did you appeal? Were you approved after the appeal? Do you have BCBS/Federal or BCBS for a specific state?

HEY FRIENDS, i'VE TOTALLY GIVEN UP ON INSURANCE AND I DON'T WANT TO WAIT ON LIST @ DARNALL. SO IS THERE SOMEONE OUT THERE WHO KNOWS OF AN AFFORDABLE GOOD SURGEON OR SOMEONE I COULD TALK TO ABOUT GETTING VSG AS CLOSE AS POSSIBLE TO MY HOME. SAN ANTONIO IS ABOUT 2 HRS AWAY BUT HUBBY LEAVING IN FEB. & i NEED TO BE CLOSER TO HOME. ALSO WHAT ABOUT THE PRICE OF VSG HERE IN CENTRAL TX, IS IT COSTLY? I'VE BEEN TO SO MANY APPTS STARTING IN 2009 AND SCOTT & WHITE FINALLY CALLED ME WITH SURGERY DATE FOR NOV. BUT IT WAS FOR THE LAP BAND. SO I CANCELLED. BUT I WONDER IF I COULD SELF PAY THERE SINCE I'VE ALREADY GOT HISTORY WITH THEM. SORRY I KNOW I'M ALL OVER THE PLACE WITH…

I've called everyday & today I was approved!!!!

I was told by the insurance company that I have to go to PCP for 6 months for weight management. Any advice on what to do? Not to do..or what to ask?

After being somewhat "on the fence" and experiencing happy/scared feelings, I finally decided, 100%, that I wanted to move forward and get the sleeve! I'm very much in the beginning stages (have only attended the informational seminar and given a copy of my insurance card) but I spoke with my surgeon's insurance specialist and I heard the dreaded words... "you have to complete 6 months of supervised dieting." After failing with medifast, weight watchers, slim fast, etc., I really don't want 6 months of, well, failure! But I just selected a primary care doctor and haven't even seen a doc for 1.5 years so I'm guessing there's no way around it. Anyone else doing the 6 …

After resubmittal I was approved this morning. The surgeon's office already called and scheduled my surgery for August 20!!! Yipeeee....I'm headed to the loser's bench!!

Does anyone have PAI or Planned Administrators? My Dr. sent everything in for review today and I wondered how long it would take to get the approval/denial.

The process of being approved by UHC was frustrating, but in the end I have been given the best tool in my fight against obesity. I look forward to finally living my life to the fullest, with my husband and 14 month old baby boy! For everyone out there don't give up.

So my refferal just went threw to see the psychologist !! ahh i hate having to wait for the docs to send the refferals in to tri care then wait for tri care to approve them then have to wait for that docs office to give me a call seems like a eternity! Im so impatient i guess thats my down fall but after the psychologist all i have to do is see the nutritionist. I wanna get everything done and over with so i can start my new life skinny and healthy. On another note i have a question what does the psychologist ask you? I mean i don't know why we have to go to one? I think its gonna be a waste of my time.I have a problem with people telling me "how do you feel about t…

Hello everyone, I was wondering if any of you have United Healthcare and your Medical Group is Affinity Eden San Leandro? I am trying to figure out if I have to do a six month diet/weigh ins with my pcp? I have tried calling the medical group and asking them if its a requirement and I cannot get a straight answer. I have also called the UHC number on the back of my card and some of the reps are saying that it used to be a requirement and now its not and other reps are telling me to ask my medical group. I am soooooooo confused. Hoping someone has been approves through Affinity Eden. Sorry this is so long:)

Sorry but I hate that people that have never met me or knows me other then claim whatever get to decide if my life is important and worth it to them to approve a better quality of life.

Does anyone have them and how much will the cover?

Just had my insurance submitted today. BMI 38 with three comorbids. According to BCBS il I will be covered but I will take all the prayers/well wishes I can. Thanks Guys!

I have received my letter of denial today. It states the a Medical director has reviewed my request and has denied it because "The documentation does not demonstrate significant obesity-related complications (comorbidities) which have failed to be controlled with medical management." I am really disappointed. My coordinator swore i would be approved because I had gestational diabetes, i have one kidney due to donating it to my father who has diabetes, kidney failure, rhinoplasty (spelled wrong but he can go blind from diabetes), high blood pressure, quadruple bypass, and some, and I was diagnosed with sleep apnea. I am so scared because all diets have failed even tho…

Well, my 23 page appeal letter was denied by my insurance. Any suggestions for the external appeal process?

My insurance approval (from Empire BCBS) came yesterday! After paperwork was submitted, it took about three weeks. I think the worst part of this whole process so far has been waiting for that approval!

Does any use united health care ( Illinois ) I was told that's going to be my new health care provider. Any info on them would be great

I just went to a local hospital seminar and found out my insurance doesn't cover this, (I thought it did Now I have to wait until January when I can change my insurance to Kaiser. Anyone have Kaiser insurance?

I was denied by cigna because the Memorial hermann hospital I chose didn't renew their contract to be a Bariatric center of excellence. How dumb is that? Then I'm told anyone who applys in the houston area through cigna will get denied if they dont go to two hospitals in northwest houston. There is a huge selection of surgeons in houston that accept cigna. To me this doesnt make sense. Then conveniently one would think the surgeons office had prepared for something like this but no. Okay so then I called all the doctors that work at the two hospitals mentioned. None of those doctors have openings till sept/oct. I know there are going to be road blocks but I can honestly s…

So I had talked to my doctor about the sleeve and suggested we try the referral process, we called Tri Care and they shot us down even before the Dr wrote the referral. 1. They still don't cover the sleeve 2. I would have to gain at least another 50 pound or have a obesity related medical condition (which I don't, but am 105 pounds over weight) we were also told I did not even meet the requirements for the other 2 procedures either. So my question is since it appears that I am going to self pay do baratric surgeons have such strict rules to have the procedure done? Also what are some suggestions to finding a surgeon to do the procedure? I have seen several people go…

I'm at the very beginning of my journey to a possible VSG. My husband is active duty Army and we have Tricare Prime insurance. The Tricare website says that they cover gastric bypass, gastric stapling and gastroplasty to include vertical banded gastroplasty and laparoscopic adjustable gastric banding (Lap-Band surgery). Would I be correct in assuming that VSG would be the same as vertical banded gastroplasty or gastric stapling?? I have yet to contact my PCM and discuss referral options in my area, so I'm literally at the VERY BEGINNING, but I thought this would be a good place to start asking questions. Thanks in advance!

I saw the surgeon at 9:30 on Thursday--August 9, it was submitted on Friday the 10th & approved this morning! Should get a surgery date tomorrow!

My husband gets our new insurance in Sept , can someone please tell me what questions I need to ask ? I want to make sure I ask all the proper questions.

The doctors office submitted my info last tuesday to insurance, today (Mon) I called and they have sent a letter requesting from the surgeon my history and physical. Anyone else have experience with this? I am waiting to see if this is something they already have or something I need to go do. Thanks,

Ok...I strongly dislike my job. The only reason why I am still there is because of the insurance. Here is the thing...my company was bought out recently by another company and before the buy out...I wasn't covered but now since the new changes..bariatric surgery is covered. Now to the point...the new insurance doesn't take in affect until January. If I happen to resign..how long can I keep COBRA and will I be covered in January once they switch over?

I would like to know if anyone has hip insurance how long will it take to be approve

Good morning all! I have completed all my doctors appointments, and my surgery coordinator will be submitting my paperwork to insurance this week. How long did it take to get your approval, and how long after approval did you have to wait for surgery! I am a bit nervous! I have BCBS of Rhode Island.

My husband and I are getting new insurance next month and I was wondering does it matter if we choose a *** or a ppo ? Also can they deny for the reason of being a preexisting condition ?

Just wondering if anyone has had any problems getting approved?

Can anyone share their experience with HCA's plans on United Healthcare? I work for an HCA hospital and am starting the journey towards getting surgery. So far I've been to the seminar, had the initial consult with the surgeon, and have been to the first medical manage weightloss appointment with the dietician. It's all out of pocket so far, because I have such a high deductible. I signed up for the high deductible plan before realizing that bariatric surgery was covered. Its the $1,900.00 deductible with 70/30 after deductible met. Fortunately the hospital stay is covered 100% with HCA hospitals. So what are any of your stories with UHC (even if you don't have HCA's p…

Just wanted to see if anyone else's surgery was approved under the short term disability? I am at that cross in my path have to submit all my information tomorrow.

My Dr's office turned everything in to Tricare on Thurs. Aug 2nd..... hoping to hear back by midweek with approval. Had my EGD yesterday, everythings in line and ready once the approval is given.... I am SOOO ready!! Hoping to hang on to my surgery date of Aug 13th!

Insurance was submitted on Friday - Aug 3. Called insurance company yesterday -they have it in the system... called doctors office to obtain the reference number that the insurance assigns when they receive the faxed documents - then phoned the insurance company today and gave them the reference number (makes such a difference to have that number) - and said it was in pending status. He said they usually take up to 5 days for approvals and then they snail mail the approval, but I can phone them and receive the actual approval over the phone and then have the doctors office do the same so we can get a surgery date scheduled. My boss is going nuts, he is as excited as …

Hi Everyone, Just wondering if any of you have heard of an insurance waiving the pre-surgery 4 month supervised diet? I've been doing Weight Watchers online for months and was wondering if insurance would possibly count that as a valid attempt. I had also lost 160lbs 10 years ago ( no surgery -- just low carb) but I have gained 60lbs back and I'm just devastated. My first appointment with my surgeon ( Dr. Lavin) is next week. The office has already verified my insurance and I am covered at a 100%. Thanks for any insight! Dana

Regarding obamacare if I turn 26 in April can I still have coverage from January till April? Sorry I wasn't sure where to ask. I'm also wondering if this means my dad would have to still pay the premium for the all of 2013 or just the three months leading up to my 26th bday.

I just got untied healthcare through my fiance how long do you think I would need to wait before I can start the lap band process

I just got my approval for my surgery today what a relief !!!

Everybody talks about their Ins maybe paying for this or that. I can't get Ins. Because I've had the lapband So I would love to know who you people have Ins. With. Mine is with Blue Cross but I have guaranteed Issue so It's high and nobody else will touch me because of the lapband.

Well, you guys were right - 3 business day's and I had my approval from UHC - they are awesome. So I call my doctor's office to inform them and to see if I can make my pre-consult appt with surgeon and get a surgery date...but they have to confirm it themselves first. they only work 1/2 day on Friday's just like me, So i warned them that I'd be callin twice a day next week so we can get this rolling - as the surgeon is only in the Richardson office on Thursdays..... I'm so excited I'm just beside myself and I got my passport in the mail yesterday so I'm ready for travel once the pounds disappear!!! going to be a great weekend........ thanks for all the kind words…

After all the troubles I've been through; my husband losing his job and, losing our insurance benefits,I have been approved again to have the sleeve. COBRA gave me a little hard time, but today I finally got my date set again,...its August 28th. I'm so excited, but scared.

I am just curious what everyone was paying for their surgery. I have seen such a wide variety of cost from 10,000 to 65,000. I know those that pay out of pocket are less expensive. I am just wondering if there are large regional differences. But I am going through Anthem Blue Cross and live in Colorado. Thanks for sharing.

Today I cried (bawled) on the phone when the nurse called and told me there is something written in my insurance that says it will not cover any type o bariatric surgery. Period! I felt like something so close was snatched away from me just like that. My husband works for the city and they have excluded bariatrics for cost reduction. So now I go self pay. It will be a struggle but this is how much I want this. Hubby wants it for me as well and has offered to cash in a retirement fund from a former job of his. I feel guilty to take this away from him but this will keep my health costs down in the future.

Does anyone here have that insurance. I know when I tried about 2 years ago they told me the doctor was in my network so that I would only have to pay my copay well fast forward a month and I have to pay his entire bill and it was almost $300 just for 10 minutes I had to set up a payment plan because I didn't even have the money to afford it. The said it was because of the cpt code and I told medical mututal thats why I called you guys in advance to see if it would be covered.