Hello, I am looking for some advice and info about having the vsg done. I am going to choose between Paramount Advantage and United Health (both Medicaid) and I'm having a hard time getting information and the requirements. A lot of post I have seen are a lot older and I'm new to this site so I am still learning how to get around. If you guys have advice or info that would be great.
Also i you know of any physicians in the Toledo, Ohio area who don't want an arm, both legs and my spine for a letter of medical necessity that would be a great piece of info to get. I only ask because I am currently looking for a new physician as I havent been going to the doctor consecutively for some time due to lack of insurance and doctors with horrible bedside manners. I went to the same pediatrician till i was 20 (24 now) and I'm sure I have plenty of medical history of morbid obesity and trying different diets, a visit with recorded weight in 2015 and 2016 or 17. Thanks for reading my post and again information you guys can give would be great!!!
I would call customer service numbers for both carriers and just straight up ask what they cover or don't and what the requirements are. Or search their websites - each plan is going to vary.
Keep on losing!
HW 271.5 (April 2016) SW 246.9 (8/23/16) CW 158 (5/2/18)
Will do!!! Thanks for replying!
Every insurance plan is different. Your best bet is to call the insurance companies, give them the info on the plan you're looking for, and ask for specific coverage requirements for bariatric surgery.
I can't speak to your experience, but I know many people (myself included) who were able to have the letter of necessity/medical recommendation written by the surgeon who was performing my WLS.
Nerdy Little Secret (#42) - Tucson Roller Derby
Yeah I'm definitely going to call and find out whats required and ask a lot of questions lol. Thanks for replying to my post!
Do you have an online account with your insurance? If so, perhaps you can download the coverage documents to get more information.
In my case, I contacted the Weight Loss Surgical Group that I wanted to use. The secretary got the requirements and gave me a list. It is lengthy; I would start getting this information as soon as possible. For instance, I had to have: cardio clearance, letter of necessity from surgeon AND primary care physician, weight checks for 6 months on a "physician-supervised diet," two nutritionist visits with a registered dietician that were at least 31 days apart, psychological evaluation, complete lab work for two different visits including a cholesterol panel, and THEN I was able to meet with my surgeon and schedule a date.
Now, hopefully you won't have all these checkmarks, but if you do you'll want to get started.
There are two ways you can proceed:
Amanda 12/2016 HW: 393 11/2017 Consult: 378 12/2018 SW: 350
2/2018: 309 3/6/2018: Broke a barrier! 297 4/2018: 286 5/2018: 279
Pre-op: -28 M1: -25 M2: -16 M3: -12 M4: -11 M5: -7
Short-term Goal: 250 by August 15th!
Wow! Thank you so much, this is very helpful! Im hoping i dont have all those requirements. But i will find out whats what. Thanks for taking the time out to help me with this, I appreciate it!!
Oh okay I was just wondering! I have never been to NHA. Which doctor would you recommend at rhat clinic? Im definitely willing to go