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

Recommended Posts

Misty- thank you for the information. I will most certainly put a folder/binder together.

Wow, July 15th isn't that far away. Congrats!!! What surgery are you having and what criteria did your insurance have? I have UHC choice plus so I'm hoping the three month program will be sufficient and not have to do the six months. I would get the surgery today if I could.

How long has your process taken?

I started my process 1/13/14. I had Molina. They made me do 6 mo program. Caresource is 9 mos. So check with the number for client services on the back of ur card for their requirements. And a tip I had to find on my own....open enrollment is coming up for insurance!! I changed mine to better suite surgery. :) Even tho it took 6 mos...it has been a journey. It is a great program with lots of info coming ur way. (Reason for suggesting the binder) I got tons of handouts....that I still refer back to.

I am so excited to be in the home stretch now....headed to the losers bench in a matter of a week!!! :) so excited!!! Please let me know if I can help with ur journey in the future.....its great to have info and a helping hand along the way!!!

Share this post


Link to post
Share on other sites

Good for you and congratulations. Please keep us posted on your progress.

Share this post


Link to post
Share on other sites

Misty- I have United health care thru my husband work. I also have to do six months but I have been seeing a diet doctor every other month for the last fourteen so I'm hoping insurance will allow that as some of my time. Regardless I have to go thru my surgeons program for three months.

I made my notebook up last night and started writing down some questions I have. Also received my health packet from clinic and filled it out yesterday. Hoping and praying they can get me in sooner than my scheduled appointment. The sooner the better.

I'm so excited for you and thank you for your support. Good luck to you!!

Share this post


Link to post
Share on other sites

Misty- I have United health care thru my husband work. I also have to do six months but I have been seeing a diet doctor every other month for the last fourteen so I'm hoping insurance will allow that as some of my time. Regardless I have to go thru my surgeons program for three months.

I made my notebook up last night and started writing down some questions I have. Also received my health packet from clinic and filled it out yesterday. Hoping and praying they can get me in sooner than my scheduled appointment. The sooner the better.

I'm so excited for you and thank you for your support. Good luck to you!!

Ty so much! If u have any questions.....hit me up. I have learned so much with dr custars team. Theyre brilliant.

Share this post


Link to post
Share on other sites

Thank you. I can't wait to meet all of them!!!

Share this post


Link to post
Share on other sites

I started my process 1/13/14. I had Molina. They made me do 6 mo program. Caresource is 9 mos. So check with the number for client services on the back of ur card for their requirements. And a tip I had to find on my own....open enrollment is coming up for insurance!! I changed mine to better suite surgery. :) Even tho it took 6 mos...it has been a journey. It is a great program with lots of info coming ur way. (Reason for suggesting the binder) I got tons of handouts....that I still refer back to. I am so excited to be in the home stretch now....headed to the losers bench in a matter of a week!!! :) so excited!!! Please let me know if I can help with ur journey in the future.....its great to have info and a helping hand along the way!!!

So good to see someone with Molina got approved! Did you have any comorbidies? I don't have any but I've been overweight for 20 years and have a bmi of 56. I'm really sticking to my pre op diet and doing everything my drs office is telling me, but I'm still so worried I'm doing all of this just for a denial.

Share this post


Link to post
Share on other sites

If Molina covers it and your are doing all the requirements then I don't see why they would deny you.

Share this post


Link to post
Share on other sites

I'm hoping to get the RNY in early October. I'm having my surgery at Riverside in Columbus with Dr. Rana. I'm really loving the program so far. Everyone is so supportive and they call you back super quick. :)

Share this post


Link to post
Share on other sites

So good to see someone with Molina got approved! Did you have any comorbidies? I don't have any but I've been overweight for 20 years and have a bmi of 56. I'm really sticking to my pre op diet and doing everything my drs office is telling me, but I'm still so worried I'm doing all of this just for a denial.

I did have comorbities. But.....I also had a bmi of 36. I think its anything over 40 they cover. I had to have a list of my morbidities and add to my bmi cause it wasnt high enuff.....but I also have 3 lung diseases and require alot of steroids. Dont sweat molina..... pqm is really good about getting it all approved. She would tell u if she couldnt do it

Share this post


Link to post
Share on other sites

I am in cleveland I have caresource now but come oct I plan on switching to molina ( bmi 44) no comorbities. Don't really have a pcp but been going to a dr for a diet program past 2 months. How can I go about finding a bariatric dr and can I start my 6 months with caresource now and switch at open enrollment

Share this post


Link to post
Share on other sites

I would check with Molina and see what the qualifications are. If you have to do six months then yes I would start now and make sure it's doctor monitored or it won't count.

Share this post


Link to post
Share on other sites

You can google bariatric doctors in your area but you may need a specialist referral depending on your insurance.i would do my own research before I decided on a doctor. Check credentials and ask lots of questions.

Share this post


Link to post
Share on other sites

I am in cleveland I have caresource now but come oct I plan on switching to molina ( bmi 44) no comorbities. Don't really have a pcp but been going to a dr for a diet program past 2 months. How can I go about finding a bariatric dr and can I start my 6 months with caresource now and switch at open enrollment

What hospital are you planning on going to? I am a patient at the cleveland clinic and I have dr Schauer and him and his team are amazing!!! Let me know if you need any advice!!

Share this post


Link to post
Share on other sites

I am in cleveland I have caresource now but come oct I plan on switching to molina ( bmi 44) no comorbities. Don't really have a pcp but been going to a dr for a diet program past 2 months. How can I go about finding a bariatric dr and can I start my 6 months with caresource now and switch at open enrollment

I am in Cleveland too. I had caresource but the diet is 9months and it's impossible for them to approve. I'm at St. vincent charity hospital and can't rant and rave enough about them. I LOVE their team and feel so comfortable there. Look into a seminar!

Share this post


Link to post
Share on other sites

So good to see someone with Molina got approved! Did you have any comorbidies? I don't have any but I've been overweight for 20 years and have a bmi of 56. I'm really sticking to my pre op diet and doing everything my drs office is telling me, but I'm still so worried I'm doing all of this just for a denial.

Molinas requirements are 3 comorbidities and a bmi of 30+ or a bmi over 50 and comorbidities no longer matter. You have to do 6 mo program. That consists of:

1. Classes (about 6-9 classes)

2. Psych eval

3. Nutritional appts (2)

4. Meet excersize coach and get measurements.

5. 6 mos of weigh ins

6. Submit to insurance and they have (by law...2 weeks.)

I hope this helps. I had molina and got approved. Surgery is Tues. :) Let me know if u have any questions.

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

    • BeanitoDiego

      I changed my profile image to a molecule of protein. Why? Because I am certain that it saved my life.
      · 0 replies
      1. This update has no replies.
    • eclarke

      Two years out. Lost 120 , regained 5 lbs. Recently has a bout of Norovirus, lost 7 pounds in two days. Now my stomach feels like it did right after my surgery. Sore, sensitive to even water.  Anyone out there have a similar experience?
      · 0 replies
      1. This update has no replies.
    • Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
      · 0 replies
      1. This update has no replies.
    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 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

    ×