I'm just curious those of you that got your health insurance to cover your lap band did you get approved the first time or did you have to do appeals? Which insurance company do you have?

thanks!

I was approved by Aetna the first time but every case is different depending on the insurance company and the requirements.

I also had Aetna and was approved the first time.

I have Regence/Blue Cross. I was approved within 3 weeks with no problem. I think they figured they couldn't lose with what they were spending on all my other problems. Half from being overweight. LOL

I was approved after the first request. I have Humana and my request was not sent to them until I had completed my 6 month supervised weight loss, psych eval and visit with the nutritionist.

Good Luck,

Deb

I was approved first request with Anthem Blue Cross/Blue Shield. This was after I met all of their requirements.

Have Highmark BCBS.. I was approved first try after 6 mon requirement met.

I was denied twice by Aetna, but finally approved on my second appeal. I had lost weight below the required BMI on WW during the past two years so that is why I had a lot of trouble getting mine approved.

BCBS Fed. Employee Program covered 85% of mine. I've paid about $600 total.

I have Aetna and it took 1 1/2 years from the first consultation to getting the approval letter. It only took 3 weeks after I got the approval letter to have surgery so that runs pretty fast but it took alot of time and documentation for the insurance to approve me. I had to appeal the first denial and it cost me $400 out of pocket but it was worth it.

I have Qualcare and got approved right away. They also pay for all my fills. My daughter who has Horizon was denied at the last minute but that is because her employer put a no weight loss surgery clause in her policy (which she was unaware of) and Horizon never picked up on until she had gone through 6 months of testing. She went to Mexico on June 6th and had the surgery all went well and she goes for her first fill Monday. And this is the amazing part she is going to my surgeon who charges me $900 (I have insurance) and is charging her $200 (no insurance) and you wonder why our health care is in the state it is in. Oh yes my surgery cost over $22,000 by the time we were done and if she had gone to him he would have charged her only $12,000!

I have BCBS Health Advantage. They pay a flat $4000 and the rest was out of pocket (they were kind enough to charge as a full cash pay patient so it was a slightly reduced rate). I was approved first time around. (actually let me clarify, most health advantage plans in Arkansas do not cover bariatric surgery under any circumstances, total exclusion, however, I work for one of the largest hospital systems in the state and they have adapted their plan to pay the $4000...not a lot, but better than nothing!)

I had Atena at the time and I was approved on the first request. I was also lucky to get my lapbanad at the right time because I was able to be apart of a study by the makers of the Lapband for 5 years. They will pay for all my fill for 5 years. So blessed!

Horizon bcbs of NJ. I have a $4000 deductable. surgeon billed 22000 with repairing the hernia. They paid $785! YES! $785! The rest is out of pocket. Approved 1st try. They said allowable $ for surgery is $4500. My doctor is appealing.

We have a self-insured plan. After my second appeal, I was approved after finding out online that surgery was allowed (after I had it done!). Since it was out of network it cost me around $4700. Unfortunately, we changed TPA's and with the plan revisions, WLS is no longer covered.

I was approved on the first try. I have BCBS of TN as my insurer. Since I participate in a High Deductible Health plan my out of pocket expenses will be $4500...most of which I paid with the things I needed to do pre-surgery.