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bb1008

LAP-BAND Patients
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About bb1008

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  • Birthday 11/18/1988

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  1. Hi there, I haven't really posted here before because I kinda gave up on the possibility of ever getting WLS because none of my employers' insurance covered it. I was recently accepted on Medicaid and I'm looking for some insight on which plans under Medicaid, particularly in Illinois, (as I gather there are different health plans under the Medicaid umbrella) cover weight loss surgery and how difficult it can be to obtain it. According to the acceptance letter I'm offered three plans: Illinicare Health, Meridian Health Plan, and Illinois Partnership for Health. I called each of the plans today and according to what I was told over the phone Illinicare and Illinois Partnership for Health do not cover weight loss surgery. Or at least Illinois Partnership for Health said they do not cover it but when pressed if proved medically necessary and recommended by a physician, I was told the doctor would submit the documentation to the state and it would be up to the state whether it was approved--there was no guarantee. Meridian Health Plan said it was covered but with the following stipulations: Must be over a 40 BMI Must complete 6 months of weight loss treatment (Weight Watchers is covered by the plan but I can choose a different one if I prefer. Also 2 nutritionist visits are covered per year) Must lose 10% of body fat (or weight, can't remember which now) within that weight loss program Once completed, I would have to work with a bariatric center of excellence for 6 months and go through the process with them. When I asked which center I would use she said she couldn't tell me because they are still working out contracts with some centers. I also got the feeling that perhaps it would be a case of using a bariatric center of excellence of their choosing. I asked because one weight loss clinic my doctor recommended was over 2 hours away and had a wait period of a year for an appointment. I tried to keep my appointment but the day before traveling there was an awful winter storm and I got into an accident on the highway on the way there. That is just one of the obstacles I've had in any attempts I've had to lose weight and I'm sure everyone here has their share too. My question for the forum is if anyone can tell me if they have had experiences with Illinois Medicaid whether with these health care plans or in general. I'm concerned if I was required to use a bariatric center of excellence of their choosing if the cards would be stacked against me. I'm worried the requirements will be so stringent that a person couldn't meet them at all. There are all sorts of stories floating around about how insurance companies can make it near impossible for the insured to get the healthcare and services they legitimately need with endless hoops and red tape that ultimately results in the person going without. I'm more than fine with doing the work, filling out forms, eating and being active as the doctor requires and anything else but to be perfectly honest I'm all out of hope. I will put in all the work necessary to finally be free of this but I want to know it's going towards accomplishing my goal. I don't know how many more failed starts I can take. I'm sure people here can relate. If you're still with me after that long post I appreciate it. I also I know Medicaid is a sore subject for some people and I'm possibly opening myself up for written lashings and judgement but I'm not sure where else to ask. I would appreciate all information and help. Thank you in advance.
  2. Happy Birthday bb1008!

  3. Happy 24th Birthday bb1008!

  4. 1 years has passed since you registered at LapBandTalk! Happy 1st Anniversary bb1008!

  5. I've been morbidly obese for several years. I've too many years on this crap and I'm really just done with being overweight. I've tried the average methods-dieting, exercise, dieting programs, gimmicks...nothing helped me lose enough weight after a certain point or keep it off. So I started looking into surgery. I was working at AT&T at the time who had Blue Cross Blue Shield then switched to United Health Care. When I called United Health Care, I was told neither Lap Band or Gastric Bypass was covered. Now that I just started at United Health Care at a call center, I was anxious to find out if the employee insurance covered bariatric surgery. When I called I received a flat toned "No" from a snotty, rude woman. She said something about no bariatric surgery being covered under UHC because UHC specficially kept that out of their policies. I was upset. Then I find this site and I see people from AT&T (wireless, just like me) saying they were not only covered but that UHC was "a breeze" to work with!! So now I'm wondering if the rude person I spoke with regarding UHC employee coverage was just too lazy to really check if their plans cover it. But this rude, "you're bothering me while I'm trying to get by NOT doing my job" attitude is something I've been met with each and every time I've called UHC--while I was working at AT&T and now that I'm an employee of UHC. I'm new to UHC and haven't even been through proper training and I may never know through new hire training what is covered for employees. So, has anyone who worked for UHC been covered for any type of bariatric surgery? I realize this is a life-long change. And quite honestly, I need it to be. I want to have a long life with my fiance (soon to be husband), with our future children and future grandchildren. I've wasted too much time stuck like this and I need something to happen or something that I can make happen. Any help you guys can give me would be very, sincerely appreciated.

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