Question:
Got a few questions that need a answer

Ok well to start off I will tell you a little about myself,I am Emilie I am 18 from ohio and am 290-300lbs n hate it have done hospital diet programs n nothing went in at 260lbs come out at it ..so that didn't work very good,but I just turned 18 12/16 n i don't have a drivers license yet will have this upcoming fall/winter when summeer hits is when i will start I am a size 26 pants n 3-4 x tops but was wondering if my insurance which is still under my moms name till I am out of school when I am 19-or if i go onto college, but its paramount advantage I have looked up all types of stuff on it to see if the lapband/relize would be coverd n have found nothing...so does anyone know if it does cover it,I have had high blood presure but it went away was on meds for 3 yrs caused by stress n also have depression but off meds now,n have been over weight since I was little,, just want to know if my insurance covers this thnks Em    — Emilie B. (posted on January 4, 2010)


January 4, 2010
You need to call the 800 number on the card and ask them if they cover WLS...Depends on what policy your mother has..Not all the Paramount Advantage insurances are the same just depends on what your mother is paying for. I would definitely call them and they can tell real quick if they cover it.
   — okbuffy

January 4, 2010
Definitely call the 1-800 number and ask them if they cover WLS and if the employer who your mother gets the insurance through covers it. That's currently my problem. The insurance company will cover it but my employer set it up as an excluded item. Best of luck. Rebecca
   — Rebecca C.

January 4, 2010
Call the 800 number and talk with them. With my insurance, it was approved on a case by case basis. They said I would have to see a Dr. and have him submit it before a decision would be made. Every insurance is different. But if you first get a no....keep trying....don't give up.
   — Janet H.

January 4, 2010
I had paramount maximum choice plan and it was an exclusion unless I met certain criteria such as high blood pressure, BMI over 40 for 6 years, diabetes, arthritis sleep apnea and some others helped me qualify. I was covered for lap band and RNY. I wanted to get the verticle sleeve (which I highly recommend you checking into least amount of complications) my insurance didn't cover that but my doctor called it a 1st stage of RNY and got it covered. I am in NW Ohio if you want some names of some good doctors, I know a few. I agree with the other posters though the first place to start is by calling your insurance company and finding out what is covered. Make sure you pursue though because the first time I spoke to them I got the right person and she saw the exclusion note and also how I could qualify for surgery. Then later my doctors office called and got someone at Paramount that said it was totally excluded but I persisted and we got it cleared up. They covered even more tha I expected. I was left with only $1000 not covered. Pretty good I thought. Also consider with the lap band there is lots of follow up over the next few years and that can be a challenge with you graduating and going to colledge and maintainging coverage. With VSG there isn't much follow up at all. I hope you have great success.
   — Lisa von Wallmenich




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