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

Recommended Posts

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 😪

Share this post


Link to post
Share on other sites

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?

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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!

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

    • Tunchi71

      3 months later and down 60 lbs......is that good?
      · 1 reply
      1. Tunchi71

        I ended up having the surgery on March 1st.

    • spatty

      June 17th is almost here. Picked up everything I need for my after surgery needs. After work will go home and finish packing a light overnight bag to make sure I don't forget anything. And the final countdown begins. Not nervous at all just looking forward to the call for my arrival time. 
      · 0 replies
      1. This update has no replies.
    • Fredeique2020  »  Catherinetheokay

      I am 19 days post op and I am still struggling to drink the fluids. I am not even able to drink the protein shakes their now nasty to me , I tried the protein bars & it didn’t end well. I have chest pains & I can barely eat. I am weak & my mouth is always dry, and feeling nauseous. Can anyone provide any advise. At least I doing the vitamins. Recently my chest & stomach have a burning sensation. 
      · 2 replies
      1. SamanthaC12

        I had a very difficult time finding protein shakes that tasted okay and didn't make me sick. I ended up drinking FairLife Core Power protein shakes. I love the chocolate (tastes like chocolate milk to me). I like to blend it with some ice and PB2 powder (or real PB) to give the smoothie consistency. I also found that if I put Panera's Turkey Vegetable soup through the blender, I could eat it. I survived off those two things. My chest pains were from the gas, which was incredibly bad and took so much longer than I expected to resolve. I'd definitely stay away from bars or anything solid until you've conquered liquids. I'd love to tell you the dry mouth will get better soon, but it didn't for me for a very long time (months). The plus to that was that I drank a ton of water. The good new is I suspect you are close to the light at the end of the tunnel on this first and hardest part of the journey. It gets SO much easier after this part.

      2. Iluvbats

        I am 2 days post-op and really struggling with everything. My depression isn't helping any. I couldn't even finish one shake today and swallowing meds is just excruciating.

    • Crystalmoon

      I am a week post op and I honestly feel like crap! I keep feeling so nauseous and I can’t get my self to drink a good amount of water. I honestly feel very regretful today. When does it get better? 
      · 2 replies
      1. adventuremomof4

        By the third week you will feel some relief. Don't push yourself too much with quantity that first week. I just made sure to keep sipping and walking which helped me feel better.

      2. Iluvbats

        I hear you. This has been the hardest day for me so far (2 days post-op).

    • Crystalmoon

      I honestly haven’t weighed myself since surgery, looking forward to doing it! 
      · 1 reply
      1. AAJamesdycle

        Im happy 6251

  • 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

    ×