I am having trouble getting approved from Molina healthcare. My doctor has sent approval saying I need the surgery and they keep not approving it. Can somebody please help me. Thank you ?

is bariatric surgery covered in your particular policy? Policies can vary among employers, even if they use the same insurance companies. Some employers choose not to include a bariatric surgery rider, even if the insurance company offers one.

if your employer's policy DOES cover bariatric surgery, do you meet all the requirements?

Yes but it is state insurance and the place that I am trying to get surgery does take my insurance.

15 minutes ago, KariLinn said:

Yes but it is state insurance and the place that I am trying to get surgery does take my insurance.

here are the requirements. Do you meet all of these? If so, did they give you or your PCP a reason for denying you?

https://www.molinacenter.com/-/media/Molina/PublicWebsite/PDF/Providers/wa/Medicaid/1023-2009_23924_CM-Provider-Bariatric-Program-Flyer-Update_nob_FNL_508c.pdf

Thank you. I have read through that and I have three things on there and they are still not approving me. I have a doctors appointment tomorrow to see what we can do. They didn’t give me a reason they just told my doctor.

You should talk to the surgery center about why the insurance is denying you. The insurance company would normally provide a reason for the denial, at least I think they do. And you can call the insurance company and find out the reason. I have had to deal with insurance companies for a chronic illness and it's really a PITA but you can always EVENTUALLY find out why something is denied.

Question: what is the difference between a predetermination letter and getting approval for the surgery? I called my insurance and the gal just spoke in circles! Finally have all my pre op requirements completed.....man, this a job!

So how did you get approved?

I haven't....I don't think [emoji848]