Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Recommended Posts

I had United Healthcare and they held up my surgery for three months. Here is the deal' date=' you have to have a co-morbidity and you have to have a doctor that is pretty high standing in this community. I gave up and my doctor's office pushed it through by getting in touch with the right people at UH. Honestly, they were happy that I had the surgery, because they are saving money on not having to buy me diabetic supplies. It is up to your doctor's office to push it through.[/quote']

Yeah I don't have any co-morbiditys...yet! I should be able to get it approved the beginning of the year. I was going to go to mx and forget the ins but my mom really wants me to stay here. But if it doesn't get approved this time I am on the first plane to mx!!

Share this post


Link to post
Share on other sites

I don't understand how the same insurance company can have so many different responses to the same surgery. I too used United Healthcare. I had to do one visit with psych, with nut and exercise therapist. Then had it submitted to insurance. One week later I had approval in my hand. I will say, we learned a year earlier when my husband had gastric bypass who to talk to. We talked to my husbands HR rep at his office. She called the insurance and requested an approval specialist with United. So United actually called my Dr office and told them everything they wanted to see. And he oversaw my case from beginning to end. There is help there. Good luck for those still waiting!

Share this post


Link to post
Share on other sites

I've been waiting for 36 months now! United healthcare wouldn't accept 3 of my 5 weights! Come hell or high Water I WILL be sleeved this next year!!

WTH! How can they "not accept" a weight?

Share this post


Link to post
Share on other sites

Keeping my mouth shut :-x. I have heard only good things about approvals from my insurance. Had my first consultation June 26 and hope to be sleeved by end of Sept. but anything can change at any moment with insurance companies.

In 3 months??! That does not count as "waiting". :wacko:

Share this post


Link to post
Share on other sites

WTH! How can they "not accept" a weight?

Because my BMI was just shy of 40. They require 5 years of 40+ BMI.

Share this post


Link to post
Share on other sites

My psych eval was just conversing with LSW not even a psychiatrist. Asked about things that happened 20 years ago. Seemed a waste of time but required.

Share this post


Link to post
Share on other sites

My psych eval was just conversing with LSW not even a psychiatrist. Asked about things that happened 20 years ago. Seemed a waste of time but required.

Share this post


Link to post
Share on other sites

In 3 months??! That does not count as "waiting". :wacko:

Really? I am waiting and thought I could talk to others waiting. Far from "wacko". Thanks.

Share this post


Link to post
Share on other sites

Reported the comment quoted abve

Share this post


Link to post
Share on other sites

I don't understand how the same insurance company can have so many different responses to the same surgery. I too used United Healthcare. I had to do one visit with psych' date=' with nut and exercise therapist. Then had it submitted to insurance. One week later I had approval in my hand. I will say, we learned a year earlier when my husband had gastric bypass who to talk to. We talked to my husbands HR rep at his office. She called the insurance and requested an approval specialist with United. So United actually called my Dr office and told them everything they wanted to see. And he oversaw my case from beginning to end. There is help there. Good luck for those still waiting![/quote']

The reason I heard is that insurance companies are putting out a lot of money to save money. For every unsuccessful person, the restrictions get harder. Right now, the success rate is 80% with this surgery. My insurance company has only had to pay for two doctor visits in the past two months compared to metaforman pills, diabetic supplies and sleep apnea extras plus doctor visits. Blue Cross Blue Shield is having a huge success that they drop the 3 month diet, whereas others are having problems with post ops. I think it is the lap band messing things up, but that is just from hearing so many people who are unsuccessful. I try to keep in mind, when I am successful, I help others become healthy.

Share this post


Link to post
Share on other sites

My psych eval was just conversing with LSW not even a psychiatrist. Asked about things that happened 20 years ago. Seemed a waste of time but required.

I had a psych eval, but it was a 500 question test. You can read about it on my blog and I have pictures of it. I laughed so hard, it took me two hours to finish the test.

Share this post


Link to post
Share on other sites

Really? I am waiting and thought I could talk to others waiting. Far from "wacko". Thanks.

I hope you don't think I was being snarky or saying this is wacko, because I was not. I would never do that, I was making an analogy. SORRY to have offended you; it was not my intent.

I won't comment again.

Share this post


Link to post
Share on other sites

I hope you don't think I was being snarky or saying this is wacko' date=' because I was not. I would never do that, I was making an analogy. SORRY to have offended you; it was not my intent.

I won't comment again.[/quote']

I am glad you clarified this. I was confused by the comment. Don't stop posting. All is well

Share this post


Link to post
Share on other sites

What was your psyche eval like. Did you have to answer a long questionaire or just converse with the psychiatrist?

My psych eval was really easy going. They ask about previous attempts at weightloss, do you exercise, attempts at changing your life style, etc. Probably the most importat thing to say is that you understand that this surgery is a "tool" to help you lose weight. Good Luck!

Share this post


Link to post
Share on other sites

It's totally the insurance company. I was approved overnight. No diets no hoops. Only surgeons hoops and they clear you through in two four hour appoinents. Hang in there folks!

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • rlcpd

      Two months out from hiatal hernia repair.  Surgeon said to expect a lot more flatulence...something about the 'air' no longer being able to 'burp' out so comes out the other end.  That is my experience but have no understanding of why that swallowed air cannot be 'burped'. ???
      · 1 reply
      1. BlondePatriotInCDA

        As I understand it since your stomach is smaller and not completely resting against your diaphragm anymore you no longer have the ability to "push" burps out as well. Plus, since its smaller and we don't digest slower the trapped air moves a lot quicker out of the stomach so its no longer available to burp out. Hence the other option for removal.

    • Lizette1122

      Anyone had the TORe procedure? How did it go? How much weight did you loose? 
      · 0 replies
      1. This update has no replies.
    • LadyVeteran1

      Sleeve surgery is on April 14th.  I am counting the days!!  Can't wait!
      · 3 replies
      1. Brookie2shoes

        Me too girl!! Are you in the full liquid diet right now? It’s sooooo hard!

      2. LadyVeteran1

        Not yet. I was told I only have to do 24 hours of a liquid diet. But I have my pre-op tomorrow so I’m going to confirm if I need to do longer.

      3. buildabetteranna

        Your so close now! It's gonna be great :) Wishing you a speedy recovery and looking forward to seeing how it goes!

    • buildabetteranna

      Down 33 lbs and slightly stalled, but I'm gonna reevaluate and push through. I started back to work last week after 2 years of being disabled due to mental health as well as my weight. It's a great job and I'm just so happy to have this opportunity at a second chance at life. Hope everyone is having their best journey ❤️ Together, we got this!
      · 2 replies
      1. DaisyChainOz

        Great work Anna! Keep it up 😁

      2. buildabetteranna

        Thank you ❤️

    • Bashbee91

      Hey guys new to the process looking forward to this new life. 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×