Does anyone have insurance with Tufts?

[LSF 264]

Does anyone have insurance with Tufts? If so, were there complicationns with them? I'm looking into the lapband but I'm worried that they will give me a hard time approving the surgery just from what I've read on their web-site.

[Ariel 1]

I have tufts and they have been soo great! Very Fast approval and they even have their nurses call me and check in to see how I am doing. I love tufts. I got banded last year so I don't know if they have changed the policies.

[LSF 264]

Did you have to wait 6 months? Would you mind giving me the specifics as to how they worked?

[Ariel 1]

I didn't do any of the interactions with the insurance company. My doctor's office took care of everything. I did wait 6 months but that was because of my school plans. Where are you from and what doctor are you using. If you are in the Boston area I would highly recommend Dr. Vernon. I love her and her staff.

[LSF 264]

I'm from Springfield. I have an appointment with Dr. Fiallo who was highly recommended by some doctor friends of our family as well as his other patients. His office participates with Tufts. I'm more disappointed about the thought of having to carry this weight around for another six months. If all the other diet plans haven't worked for me over the past 30 years, why would it now? That's why I would like to have the surgery. I've already met with the Nutritionist and had a stress test. I'm going back for a nuclear stress test this week - my blood pressure was fine but they spotted something on my EKG.

[daisygurlvb 0]

I have Tufts EPO. They have been fantastic. I'm in the middle of the six month program now. It's called the "I can Change" program. It's a series of phone calls with a health coach. I'm in month 4. There's really been no weight loss requirements from them, only from my surgeon, and it was of 15 lbs total. I already have my surgery scheduled for May 14th, which will be after my 6 month program. I just hope I don't have problems with getting approved. Good Luck!!

[LSF 264]

Actually - I completed the program and had the surgery on 11/19th. Once it was completed - Tufts moved very quickly. Good luck to you!

[daisygurlvb 0]

OMG. I'm so sorry. I misread the date!! LOL I feel foolish!

I'm glad it ended up working out for you, and I'm glad to hear they approve quickly!

Good luck in your continued journey!

[LSF 264]

Thanks! The best thing is that Tufts cocers the first 90 days of appointments so I was able to get my first 3 fills for free. But my co-pay went way up this year, my fills will cost me $45.

[daisygurlvb 0]

That is very encouraging news!! Thank you so much for sharing.

I'm sorry to hear about your co-pay going up. Mine are currently $5 an office visit. I hope they don't go up! lol. I'm very lucky to have such a good plan. I've been reading posts about people and the money they spend is so much!! Yikes!!

Good luck!!

[Watelu 0]

I also have Tufts and am going through PVSA. I completed the I Can Change program. Waiting the 6 months is no fun, but in retrospect it gave me time to try (once again) to lose the weight on my own--convincing me that the lap-band is the right choice. My one word of caution is this: I was scheduled to have surgery 2/23 and found out yesterday at 4:00 that Tufts will not pay for it unless I go to another hospital--now I must wait until 3/13, rearrange work, etc. Tufts was very quick with approval (about 2 weeks once paperwork was handed in), but this hospital thing really messed things up! Good luck with everything! PVSA has been great, esp. with the last minute rescheduling to get me in ASAP.

[daisygurlvb 0]

I'm new to the board, so sorry if this question sounds funny, but what is PVSA??

When I first started this process 4 months ago, they told me to choose from a specific list of hospitals, so I did. Mine's going to be at Brigham & Women's Hospital, on May 14th!

[LSF 264]

I also have Tufts and am going through PVSA. I completed the I Can Change program. Waiting the 6 months is no fun, but in retrospect it gave me time to try (once again) to lose the weight on my own--convincing me that the lap-band is the right choice. My one word of caution is this: I was scheduled to have surgery 2/23 and found out yesterday at 4:00 that Tufts will not pay for it unless I go to another hospital--now I must wait until 3/13, rearrange work, etc. Tufts was very quick with approval (about 2 weeks once paperwork was handed in), but this hospital thing really messed things up! Good luck with everything! PVSA has been great, esp. with the last minute rescheduling to get me in ASAP.

What hospital are they making you change from? I also go to PVSA - I was supposed to have my surgery at Baystate but they moved me to Noble because I was 'low risk" and Tufts covered it.

[Watelu 0]

I was originally scheduled at Noble for Feb. 23, but only after my pre-op appointment did I find out that Tufts will only cover it at Baystate. Noble doesn't have as high a rating as Baystate hence Tufts will only pay for it there. I'm not sure if this is a recent change. PVSA (Pioneer VAlley Surgical Assoc.) said they had not run into this before. So now I'm waiting until 3/13 :tt2:!

[LSF 264]

Maybe this went through after the New Year. I'm surprised because I think it's cheaper to do it at Noble - it would save the insurance company more money.