I have been watching this thread and researching for probably a month now and decided to speak to my dr about the gastric sleeve! I do have a BMI of over 40 and no other Problems so I thought I should be a good candidate for the surgery... Well today was the day I thought I would get some answers regarding insurance and requirements and atleast get the ball rolling .... I was totally wrong !!! My Dr. Was the least supportive she didn't have much to say other than usually insurances want to see 10 percent of your weight lost and maintained for a year before they will even consider you ... This was just so discouraging because when I asked her about my insurance and what they require I was just told to call them and find out... I feel like I am starting the process alone!! Has anyone had this happen? I just want to get a start to it , I know surgery won't happen over night I just felt like she was so unsupportive !!

I changed doctor's also because I was not happy with her responses on my health and WLS. My second dr did not agree with weight loss surgery for me at first, but after a few years and my dr becoming one of the bariatric board members she started supporting me. I was suggested to lose 10 percent of my weight, but I did not lose the whole 10 percent.

Went to a different Doctor today and she sent the referral in for bariatric surgery!! She didn't mention anything about waiting a year to lose 10 percent of my weight or anything Yay!! I know there's still a long way to go but so happy finally a doctor listened to me!! So I guess the next step is to wait for the insurance to fire a letter back of requirements or something .. Does any one know ? I am just so excited the first step of many is done !

Went to a different Doctor today and she sent the referral in for bariatric surgery!! She didn't mention anything about waiting a year to lose 10 percent of my weight or anything Yay!! I know there's still a long way to go but so happy finally a doctor listened to me!! So I guess the next step is to wait for the insurance to fire a letter back of requirements or something .. Does any one know ? I am just so excited the first step of many is done !

They will have you attend a bariatric seminar. There they will weigh you in and education on the process. They took my insurance info that day too. Usually bariatric teams include a group of people who just work onyour approval process

As mazzers120 said, check out some local bariatric surgeons in your area, and go to a few seminars. They are free and will help you in figuring out insurance and other questions you may have. I went to one seminar and ended up at another practice, but I was able to use all the forms and information from the seminar to get the ball rolling. Good luck!

Hey everyone!! Thought I would just update every one on my very beginning of my weight loss journey!! So last week my doctor sent in a referral to see a bariatric surgeon! Well today I was notified by the surgeons office at Cedars Sinai in LA that they received my referral and that I could make my appointment for a consultation with the surgeon!! So today I got my appointment scheduled and my seminar both on the same day! Both scheduled on November 21!! So excited and nervous at the same time!! Would def appreciate any feedback you have

Edited November 5, 201312 yr by LaurenB8604

Lauren - I'm not sure of what insurance you have. But Cigna will require a letter from your PCP. That states they "medically clear" you for the surgery. This exact words need to be used.

Initially my PCP wrote that he commended the WLS and I have struggled thru various weight loss programs with no long term success. It was a great letter. But Cigna still wanted another letter stating he "medically cleared" me. I wish you well!

Carmen- I too have Cigna (of Tennessee) and I will be seeing my PCP on Friday. I have no idea if she will be supportive of WLS or not. I have researched the hospital and surgeon I would like to use. Do I just ask her for the "Letter of Recommendation" or will she need to fax it. I don't do well with confrontation but I have educated myself about WLS and feel this is what I want to do for my health. I sure hope she will be on board with my decision.

Thanks for any help you can give.

Andrea,

You can compose your letter of recommendation. Ask you insurance provider or read your plan docs for the explicit info they require from your PCP recommendation. The easiest thing to do would be to call Cigna.

I would write down the bullet points you doc needs to include in the letter for you.

It makes it easier for them and will save you time. Then have the PCP fax that letter to your bariatric surgeons insurance coordinator. It needs to be in the docs that are submitted to Cigna.

Hope this helps!

Carmen,

Thank you for the info. I plan on calling Cigna in the AM. I am so excited to finally get the ball rolling.

Carmen- I too have Cigna (of Tennessee) and I will be seeing my PCP on Friday. I have no idea if she will be supportive of WLS or not. I have researched the hospital and surgeon I would like to use. Do I just ask her for the "Letter of Recommendation" or will she need to fax it. I don't do well with confrontation but I have educated myself about WLS and feel this is what I want to do for my health. I sure hope she will be on board with my decision.

Thanks for any help you can give.

Andrea -- I just got my approval from Cigna. My PCP had to write a letter that he both recommended me and medically cleared me for surgery. He wasn't super excited about writing it because he's a bit more of a naturopathic kind of guy, but he did it. He initially wrote it incorrectly (maybe on purpose -- ha!), but my surgeon's office called me for approval, then called him to give him the specifically required verbiage. Once everything was in, my approval process was pretty quick. Surgery December 3.

I have anthem blue cross of California, does anyone have any experiences with them ?? I go a week from Thursday for my class and than my first consultation with the Surgeon! Not sure what to expect but very exciting !!

I know im late to the thread! BUT you are not alone! My doctor was not very supportive. I instead called my insurance and figure out how to do it all on my own! I luckly did not need a referal though. Sometimes you come upon glitches that are frustrating! Do not be detoured! Keep trucking along. I have a 6 month wait ahead as well! ONE STEP AT A TIME! This site is so helpful! Like minded people! We know what each other are going through!

Wow- just got off the phone with Cigna. They said don't worry about the letter. The Hospital I am looking into having my surgery will begin pre-certification with Cigna. They will contact my PCP and request all information that is needed. My insurance does not require my PCP to give me a referral. So if she is not on board with my decision to have WLS it will not affect anything in the process.

You all have been so great. I am so glad I came across this site.

Lauren, I have Anthem BC of California. My husband works for FEDEX out here in PA. let me tell you, they are a joy to work with. I called them after my info session to see if I was covered. I was. I asked them what I needed to do in order to get approved. Was told that with a BMI of lower than 40 I needed two comorbids. Needed just one over 40 BMI. I didn't need to do a doctor supervised diet. They just wanted certain tests done and a recommendation letter from my PCP. I took care of EVERYTHING Anthem wanted and then took care of all the tests my surgeon required. My whole process took just under 3 months. I was sleeved on October 22, 2013 and haven't looked back since. Good luck!!

My meeting with my PCP went well. She is supportive of my having the surgery. She is willing to do all she can to help me have a successful outcome.