Just wondering if anyone has this insurance and if you had any problems with approval

Anthem, as a whole, covers the sleeve as of November 18, 2010. They follow the Wellpoint utilization management guidelines for their medical policy on bariatric surgery.

General requirements are:

:: BMI over 40

OR

:: BMI between 35 and 39.9 with additional co-morbid conditions (diabetes, hypertension, hyperlipidemia, cardiovascualar disease, severe cardiopulmonary disease)

:: History of non-surgical weight reduction attempts

:: Psych consult

:: Medical Clearance

:: Pre- and Post-op Diet and Nutrition Counseling

:: Ongoing follow-up and support/education/counseling resources

That said, every plan is different and some employers/plans may specifically exclude bariatric surgery as a whole or my put additional requirements in place. It is always best to call the number on the back of your insurance card and ask specific questions and ask for a copy of the medical policy (it is usually available online).

I've worked mostly with Anthem Ohio and Anthem Kentucky, and the predetermination/pre-certification process is fairly painless as long as your doctor submits the required information. I think their predetermination process takes a week or less, but don't quote me on that.

Well Thanku for the reply. I very much appreciate it