Insurance question

[Tanya Gif 23]

Hi All,

I see many of you posting that you will be getting your VSG surgery done in Mexico due to not being approved by insurance. Can anyone of these people please share why you were denied by your insurance.

I have Oxford/United and have completed all their requirements including the 6 months of nut visits. The office manager gave a surgery date already once my nut cleared me, which if Feb. 26! She also scheduled me for pre-op testing at the hospital. I'm still a bit nervous that the ins will not approve me and I'm already getting excited about the surgery. Any thoughts on this issue?

[brebbugbrielle4 21]

I'm rowing the boat next to you. My date is suppose to be 2/4/15 but I'm too nervous that I will be denied to even be excited ???? Hope we both get some good news. Good Luck ????

[Jersrose43 837]

Hi All,

I see many of you posting that you will be getting your VSG surgery done in Mexico due to not being approved by insurance. Can anyone of these people please share why you were denied by your insurance.

I have Oxford/United and have completed all their requirements including the 6 months of nut visits. The office manager gave a surgery date already once my nut cleared me, which if Feb. 26! She also scheduled me for pre-op testing at the hospital. I'm still a bit nervous that the ins will not approve me and I'm already getting excited about the surgery. Any thoughts on this issue?

Call and clarify a few things

Call the jnsurance. Have you received an authorization request for surgery from dr x in day x? What is auth number ?

Call doc insurance coordinator. I. Called united they don't have me as approved yet - what's up?

[Jersrose43 837]

As to why people go to Mexico. What I've seen posted is the top reasons

1- I don't have insurance

2- my insurance specifically excludes it.

3- I don't want to be bothered with 6 or 12 or more months of nutritional counseling.

4- I got denied a couple times - or once- and don't want to go through hoops

[Tanya Gif 23]

Thanks you! That clarifies things a bit

[Alora VSG Begonia 53]

Tanya, I'm getting mixed info from u my doctor and I also have Oxford/UHC. My doc and surgical coordinator are just saying all I need to do is come in for six weigh ins and see a nutritionist, no weight loss required. I've seen other people have to turn in like... food logs and stuff. Did you need to do any of that for Oxford? Did you end up getting approved?

[Tanya Gif 23]

Hi @Debranua. Yes, my ins coordinator told me the same thing, that weight loss is not required. I completed all me nut visits but still don't know if I am approved (haven't been able to reach them). I will let you know as soon as I hear anything

[Mel24 51]

My sister just went to Mexico and had the VSG done. Her insurance doesn't cover it at all-no matter what. Thankfully mine does. She had a very successful surgery last week, and has already lost 8 lb. I don't think I'd have the guts to go south to do it.

[Stephanie Salsera Perrott 85]

Everyone on the boards keeps saying UHC Oxford does not require weight loss. I've gained a few lbs due to flu etc... and I'm soooooooooooooooooooooooo worried HELP!

[Jersrose43 837]

Everyone on the boards keeps saying UHC Oxford does not require weight loss. I've gained a few lbs due to flu etc... and I'm soooooooooooooooooooooooo worried HELP!

You should pick up the phone and call them directly. Get it from the horses mouth based on your specific plan

Uhc sells thousands of policies and since most of them are employer funded the employers can make whatever rule they want.

Real answers come from the single fountain. Not a forum. Get on the. Phone and then get a name of who you talked to

[AquariusDiva 15]

Another reason some choose to go to MX seems to be that they are on the low end of BMI- like being 39 Bmi with no co morbidity or under 35 bmi. I know a low bmi person who got the lap band in MX.

As far as insurance denial - I was denied by UHC due to missing one year of recorded weight by my doctor and one low weight year (part of the five year medical history). But we appealed based on high weight records dating back more than 5 years ... And that appeal worked. I was then later denied by cigna based on the 12 month rule for surgeon, Nut, and psych evals. That was reversed once I did another visit to all three. It's been a long process for me. ... Started back in dec 13. Just got the last insurance approval. Surgery set for 3/16.