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Showing results for tags 'coverage'.
Found 9 results
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I ran into an issue today with my Highmark Flex Blue PPO 1000 insurance. The first rep I spoke to in Feb, said that I would have to cover 20% of the sleeve surgery, but today the rep said I wasn't covered at all for anything and there were no notes about the previous rep I spoke to. Because of my income I can get on Medicaid in Pennsylvania. I have been paying for insurance out of pocket, because I like my family doctor and I didn't want to have to go to a clinic. However, the surgeon's office said that it will be covered 80% and there maybe other things like the hospital that won't be covered. Has anyone in PA used medicaid for a sleeve? Does anyone think that I should spend more to get a new policy from Highmark which does cover surgery? Any other suggestions/help? Thank you!
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I am only 3 three weeks out and just starting occasional thick liquids after my sleeve. I have GERD and it seems any food bothers me. I know sometimes this can lead to a revision. My insurance changed 4 days after my surgery and my new insurance doesn’t cover wls. Would it be covered!
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Hi. Im new to this site and I have a few questions. I live in Nashville Tennessee and I'm wondering if medicaid will cover a VSG surgery for me. Im diagnosed morbidly obese. Im 5'5" and 400 pounds. Im on Lisinopril for blood pressure, Lexapro for anxiety, Metformin for Insulin Resistance (thats right before full blown diabetes), I have arthritis in my knees and ankles and trouble getting around, and I suffer from nasty migraines. I've also been having trouble getting enough breath. I always seem to be panting as if Im out of breath, even when I dont do anything. I just moved here, but my doctor in Virginia had me on several different things over the last 3 years. Alli, Sensa, Atkins, low calorie/low fat diet, and nothing worked. I use to be able to drop 20-30 pounds over the course of several months (although it always came back) but in the last year I havent been able to lose anything. I'm wondering if Tennessee medicaid will cover the VSG surgery if my new doctor recommends it. I cant afford to pay out of pocket, but I'm ready, determined, and excited to get on this weightloss journey. I have 2 kids that i want to be around for. If anyone has any insight into wether Tennessee medicaid will cover the vsg, please let me know. Thanks so much!!
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Hello, I'm hoping for some positive vibes.. Here's my situation... I work for a managed hotel company, and the old management company returned us to the bank and a new management company came in.. Unfortunately my luck, the old company agreed to pay Cigna premium through October 31st and my last nutritional appointment is Monday, November 2nd. The new company looked for a new insurance for us but it's "individual" and not a company "group" insurance through United Healthcare. I called the number they provided and they said bariatric surgery is not covered since it's an individual plan. I looked at Cobra and it's $738 per month. Yes, nauseating. I called Cobra and Cigna and they said I would still be covered if I Cobra. After calling all insurance and getting it cleared, I decided to Cobra. I wrote a check today for $1476 to cover me through December. Thankfully I can pull that from my savings. Everyone at my job is freaking out about the insurance because the United Healthcare policy is extremely high and barely covers anything. I then called the bariatric center and I told her the information and thankfully they've been super helpful. They said as soon as I come in next Monday for my last nut appointment that they would submit that Tuesday so we can move the process quickly. She said if all goes well, the surgery would be about the 2nd week of December if Cigna approves within the time frame they usually do and they don't bounce back the paperwork. I just have a lot of anxiety with this insurance. It's like I'm almost there but I keep getting pulled back. My mother said it will all work out. I just need to stay positive. Has anyone else gone through a cobra situation? Thank you!
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Had my surgery on 3/10/21, this getting my denial overturned on 3rd appeal. I am now getting a bill for the full cost of anesthesia that states "we do not offer coverage for this type of sedation" . . .WHAT!? I don't even know where to go from here, how can this be something new?
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I am in a position where I am ready to try to revise my lap band to a sleeve surgery. My current insurance will not cover a revision or removal unless "medically necessary", and apparently extreme side and shoulder pain along with damage to the nerves that control the diaphragm is not a "medically necessary" reason for removal I am looking for an insurance company in Oregon that will cover a revision surgery, or a sleeve surgery if I can pay to have the band removed myself. I've gotten to the point of desperation, even calling various surgery centers in Oregon and asking about which insurance companies they work with has gotten me nowhere (doctor/patient confidentiality I suppose). Soooo... with that said, what companies in Oregon did you use that approved your sleeve, and what is the plan name or coverage level? Any answers would be so greatly appreciated (:
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Healthcare Exchange: States that do not cover Bariatric Sugery
OutsideMatchInside posted a topic in Insurance & Financing
*States that do not offer bariatric surgery, nutrition counseling, or weight loss programs in the State Health Insurance Marketplace are: Alabama Alaska Florida Georgia Indiana Kansas Kentucky Minnesota Mississippi Missouri Nebraska Pennsylvania South Carolina Wisconsin Source http://nofusa.org/news/health-insurance-cover-obesity-treatment/- 15 replies
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19 year old in the process of VSG!
BriAlexis posted a topic in PRE-Operation Weight Loss Surgery Q&A
Hi all! I’m a 19 yr old young woman in the process of getting a VSG. WEIGHT: 358 lb HEIGHT: 5’5 BMI: 59 I’m kind of doing this alone so I desperately need advice and answers from anyone who can help. I’m on month 3/6. So far, I’ve met with my doctor, I’ve had labs done, and now my next steps are to meet with the surgeon, dietician, and have my psych evaluation. I need to know when should I contact my insurance (sorry if that’s a dumb question). I’m on my mother’s plan, and we have BCBS (IL) Anthem w/ PPO Suitcase. Is the gastric sleeve covered with them? When will I find out if it’s covered or not? Thank you for your help! -
So I payed a visit to my PCP and discussed VSG, and he was all for the idea so I was jumping for joy. I THOUGHT that would be the hardest part of this process and I thought for sure that I had this surgery thing in the bag, good lord was I wrong. I have to admit that I'm super naive to how all this insurance stuff works, having the luxury of my mothers help my whole life. Well, after my PCP visit, I decide to "come out" to my mother (having not told anyone, because I feel it's humiliating ), explaining that I decided VSG was for me. Come to find out, our insurance doesn't cover WLS, under no circumstances, no matter what comorbidities you may have or what your bmi is. So now I've been cracked out, doing my research, looking for new insurance. I read stories about how people go from PCP to surgery in a month....how?! Everything i'm finding requires like 6 month medically monitored diets, and however many months of counselling...blah blah blah. Now that I see I have so many road blocks, I'm feeling a bit discouraged and defeated. How did everyone keep their sanity while doing all this nonsense? Or maybe any insurance suggestions? I just want to get the ball rolling already!
