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does your insurance know that you are going for WLS?

I have only been working with my weight loss clinic. I have not talked to my insurance, should I be contacting them?? Telling them what I'm doing?? I'm just confused, wls clinic says we take care of everything. I'm not getting warm fuzzing feeling with reading the posts on here. Please if you have any suggestion!!!

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  • Yes, my insurance covers weight loss surgery. I did speak to them to confirm. Just wondering if I need to keep in contact with the insurance? I see on here that people have an insurance coordinator

  • FitnFabfor2014
    FitnFabfor2014

    Hi. Before I even went to a weight loss seminar (with my doctor), I contacted my insurance company to confirm gastric surgery was covered. The insurance company sent me an information packet on what

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I have only been working with my weight loss clinic. I have not talked to my insurance, should I be contacting them?? Telling them what I'm doing?? I'm just confused, wls clinic says we take care of everything. I'm not getting warm fuzzing feeling with reading the posts on here. Please if you have any suggestion!!!

Has your weight loss clinic confirmed that you have insurance coverage for your surgery? Have you checked to see if it is covered by your employer? You should be able to find this out from the web site of your insurance company and by logging in with your credentials. I have UHC and my employer goes through Optum. I contacted Optum as well as the insurance coordinator at my doctor's office. I received in writing the criteria they use to determine weight loss so there were no surprises. If your insurance company requires a medically supervised diet for a certain period of time, find out if the appointments have to be consecutive.

The more you know up front, the less likely you are to have a surprise down the road. Good luck. It would be a shame to start the process and think you are close to find out you have a six month med sup diet or something else.

Has your weight loss clinic confirmed that you have insurance coverage for your surgery? Have you checked to see if it is covered by your employer? You should be able to find this out from the web site of your insurance company and by logging in with your credentials. I have UHC and my employer goes through Optum. I contacted Optum as well as the insurance coordinator at my doctor's office. I received in writing the criteria they use to determine weight loss so there were no surprises. If your insurance company requires a medically supervised diet for a certain period of time, find out if the appointments have to be consecutive.

The more you know up front, the less likely you are to have a surprise down the road. Good luck. It would be a shame to start the process and think you are close to find out you have a six month med sup diet or something else.

  • Author

Yes, my insurance covers weight loss surgery. I did speak to them to confirm. Just wondering if I need to keep in contact with the insurance? I see on here that people have an insurance coordinator they talk too. I haven't done this, is it something I should do??

I started my process with the wls clinic in August. Yes, I do have a six month supervised diet requirements. I did start in June with my pcp she prescribed me phentermine. Do you think that would count as part of the six months?? So with that being said I would say November would be six consecutive months, what do think??? Would like to have this done before the end of the year only because not sure what my insurance deductible will be in 2014!!! Right now it's $1200.

I have private insurance and I know that if they found out I was over 200, not only would they not approve the surgery, but they would drop me from my plan and I would end up with no insurance at all. I used the self-pay option and I have been very careful to keep my insurance entirely out of the loop.

Also...if you're using your insurance company I imagine letting them know what's going on ASAP is a good idea so that if they come back with major conditions you have plenty of time to resolve them.

The only time I spoke to my insurance company was to call and see if they had a response on my submission yet. My clinic took care of everything. If in doubt follow up! You don't want to regret it down the road. I felt very comfortable and confident with my clinic. They took my insurance information and called me and went over exactly what my insurance company covered and I did end up getting a letter from my insurance company, because the clinic asked for pre authorization on X amount of visits and they OK'd me up to 99 visits in 2013.

I have only been working with my weight loss clinic. I have not talked to my insurance, should I be contacting them?? Telling them what I'm doing?? I'm just confused, wls clinic says we take care of everything. I'm not getting warm fuzzing feeling with reading the posts on here. Please if you have any suggestion!!!

Hi. Before I even went to a weight loss seminar (with my doctor), I contacted my insurance company to confirm gastric surgery was covered. The insurance company sent me an information packet on what I needed to do (physicals, pap smear, weigh in's etc.). I was assigned an insurance coordinator through my insurance company and I have a coordinator through my doctors office. Apparently the doctor's office that I going through know's everything that has to be done, so my insurance coordinator has asked me to refer all my questions to the doctor's coordinator (strange I know). I have contacted my insurance to verify my only co-pay is the hospital stay. That is it, the insurance will cover the rest and my doctor's office coordinator answers all my questions. If the clinic is good at what they are doing you will not need to fight with your insurance company. My insurance told me that the doctors office would not even let me get this far if I wasn't a candidate. I am hoping for a December surgery. I am soooo keeping my fingers crossed! :ph34r:

Good luck to you!!!

Yes, my insurance covers weight loss surgery. I did speak to them to confirm. Just wondering if I need to keep in contact with the insurance? I see on here that people have an insurance coordinator they talk too. I haven't done this, is it something I should do??

I started my process with the wls clinic in August. Yes, I do have a six month supervised diet requirements. I did start in June with my pcp she prescribed me phentermine. Do you think that would count as part of the six months?? So with that being said I would say November would be six consecutive months, what do think??? Would like to have this done before the end of the year only because not sure what my insurance deductible will be in 2014!!! Right now it's $1200.

It depends on what your six month requirement is. I know my surgery doctor visit counted into my 6 month requirement, my primary care appointment did not (maybe because it wasn't through the surgery clinic). You raise a good question there though, maybe I should ask and it will take off another month :wacko: .

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