NEW! Starting the process and am a little confused.

[BLERDgirl 6,417]

I agree with @@samuelsmom . I'm also pretty sure they have to inform you if a procedure is covered or not. If the rep you speak with doesn't know, ask for a supervisor. It literally should say whether or not they cover vertical gastrectomy. If you have any copays for elective surgeries they should also have that info. I knew going in that my copay for surgery was $400.

@@alindsey - I worked in social services so I know how systems work. It makes me mad and I dig in and fight.

[dandylion_23 5]

The guy my husband talked to read from our benefits and it says our plan covers bariatric surgery and has to be submitted for pre auth. We have our book as well and I've read it from cover to cover and there is just the 1 section on weight loss. It will not pay for weight management programs but covers bariatric surgery and has to be submitted for pre auth. Same thing he said. Is it possible it's that easy? We do have amazing insurance. I just find it hard to believe it could be so simple. I have hope being I've seen others posts.

[mandaroo 78]

I thought the same thing... I thought the process was going to be alot more complicated, one of the reasons I put it off for so long. My advocate said I have awesome insurance and there was not a whole lot of hoops to jump through.

[BLERDgirl 6,417]

It could be that easy. My process was 4mths from initial consult. I went to an informational seminar the end of April. Had my initial consult in May, surgery in September. Of course there was the various testing and I had monthly meetings with my surgical team, but it was fairly simple. Not all insurances require medically supervise diets. In the end the process for most of us is a combination of program requirements and insurance requirements. However if you know for sure you want the sleeve, I would specifically ask if insurance covers vertical gastrectomy. Some insurance cover bypass and lapband but not sleeve and I would hate to go through all that pre-op testing only to be told that at the end my option are those 2 only when my heart was set on the sleeve.

[perk4756 259]

I only have to do a liquid diet the last 12 days before to get ready. My doctor somehow gets by the 6 months. And is making 4 months. My start date is April 1st and end supposed will be in August. They say it's because if how they schedule all of it. I had 3 appointments my first visit actually.

[della street 213]

@@BLERDgirl Good point -- that actually happened to me. BCBS initially told me that they covered band, bypass and sleeve. Yea me! Doctor and I decided on sleeve. Yada yada yada -- oops - they covered those three things in "grandfathered" (ie, older) policies, but in "non-grandfathered" policies (I purchased my policy on the Affordable Care Marketplace this past January), they only cover band and bypass. Go figure, no one could tell me why, not that it mattered -- that was what they covered, end of story. So I felt blessed they covered it at all -- so I had bypass January 29th and am very happy with that decision and doing well.

On a weird side-note -- I actually received an approval letter from BCBS approving "sleeve" - I said, wow, you now cover it? They (surgeon's office and BCBS) were confused as to why I was confused about getting sleeve covered -- then *I* had to point out to them that they previously told me that sleeve was NOT covered by my non-grandfathered policy (after telling me that it was, but I digress...)

All's well that ends well, but OY OY OY.

[dandylion_23 5]

I only have to do a liquid diet the last 12 days before to get ready. My doctor somehow gets by the 6 months. And is making 4 months. My start date is April 1st and end supposed will be in August. They say it's because if how they schedule all of it. I had 3 appointments my first visit actually.

i will have 3 appointments my first visit too. Starting at 915am lasting until about 1.

[dandylion_23 5]

It could be that easy. My process was 4mths from initial consult. I went to an informational seminar the end of April. Had my initial consult in May, surgery in September. Of course there was the various testing and I had monthly meetings with my surgical team, but it was fairly simple. Not all insurances require medically supervise diets. In the end the process for most of us is a combination of program requirements and insurance requirements. However if you know for sure you want the sleeve, I would specifically ask if insurance covers vertical gastrectomy. Some insurance cover bypass and lapband but not sleeve and I would hate to go through all that pre-op testing only to be told that at the end my option are those 2 only when my heart was set on the sleeve.

I specifically asked if it was covered and they said pre auth is all that is needed.

[dandylion_23 5]

You folks are all amazing!

[perk4756 259]

I called the insurance about the sleeve before I even had my first appointment. And I also wanted to know my part if the cost. It is only the yearly. $250 deductible. I also have called to now find that with a prescription a portion of my Protein Drinks will be covered. Very excited about that. Had found on insure.com sight the as t they may