Question:
How long should i wait (part 2)????

thanks to u all that anwsered my question, i find this site so helpful,,, but some of u ask was there and waiting period on my policy, i do have a 1 year waiting period on all NEW pre-existing conditions, but i have no new pre- existing conditions unless they will consider my obesity to be pre-existing and try to put me off because of that---i hope not,,,, my bmi is a staggering 47, i hope thats enough to get me the surgery,,,, and hope they dont consider my obesity to be pre-existing med. condition or im afraid they will make me wait the year,,, thanks again for the input!!!    — cbryant (posted on November 27, 2007)

November 27, 2007
New pre-existing conditions? That sounds like an oxymoron. If this insurance company is too difficult, most companies that offer insurance, offer a selection of choices. You may want to investigate the others, or check further with your current insurance company
   — Dave Chambers

November 27, 2007
sorry about the confusion of my question, i meant there is a 1 year waiting period on all pre-existing medical conditions, and anything condition not pre-existing is covered ,,, so i hope they dont consider my obesity to be pre-existing condition and make me wait the year..... sorry about the confusion
   — cbryant

November 27, 2007
I have BCBS HMO and they considered my obesity a pre existing condition and made me wait a year....But it was worth it! Once the year was up I was approved in two weeks and scheduled for surgery in another three. I'm now two months out and have lost 32 lbs and feel absolutely great. I took that year and somehow managed to lose 14 lbs and got in my six months of supervised diet.
   — gretamarie

November 27, 2007
I believe pre-existing means something you where treated for prior to getting this insurance. If you have had treatments specifically for obesity then you might have to weight; however, if not then forge ahead. You might want to check with them though to see what the person on the other end of the phone has to say if you don't find it in your documentation or on the website. I like to check my insurance company website for position papers on medical issues -- they tell you more than the person on the other end of the phone.
   — the7thdean

November 27, 2007
When in doubt, contact your ins company. I have Independant BCBS and I called them and they were very helpful. I had to do the 6 mo supervised weight loss classes, but the bariatric clinic I went to had 2 certified dieticians that did the classes and it just gave me more time to learn all I could about RYN and lapband. Do not be afraid to ask questions. It is your policy and you have a right to know what your insurance guidlelines are for you surgery. Alot of times the doctors offices just kind of use the most common guidelines for everyone until they get more specific ones from your ins. I would check and see if obesity is considered pre-existing, make sure the surgery is a covered benefit on your specific policy, see if a 6 mo weight loss class is required, and see if they require 2-5 yrs of documentation showing your history of obesity. Once I was done with the classes I called my ins comp and started the process myself. I got really lucky and my ins did everything over the phone, so it took like a week and I was approved and had my surgery 3 weeks after that. I work for an ins company so I had access the the diagnosis code and procedure code your ins would need to authorize, but you can also get that from your doctors office IF you wanted to do it yourself. Be VERY proactive in getting this done. I had a friend who had her request submitted to the wrong place and it set her back over a month. She got the info herself, mailed it to her ins with a signature receipt required and was approved the same day they recvd it. Your BMI in and of itself SHOULD qualify you. Most ins say a BMI of 40 OR 35 w/ co-morbidities. So, definitely call and check or if there is a website you can go to do that. I didn't find the website for my ins comp or the policy book to be very specific. I had to actually speak to someone. I know this is a lot of info, but I hope it helps! :) Good luck, and here's hoping your ins doesn't consider your obesity to be pre-existing! Julie
   — juliebelle0402

November 28, 2007
I hate to say it and hope I am wrong, but I would think they will consider your obesity a pre-exsisting condition. Mine did. Also, they may try to fight you on your BMI. Most insurances wont even consider it unless your BMI is the low 40's and I know mine ups the smount of co-morbities you have to have in order to qualify, the lower your BMI. For instance, at your BMI, my insurance would make you have 3 co-morbidities (three things that couldp potentially kill other than obesity) to even consider it. It took me a little over a year to get approval at a BMI of 54. I hope your experience is better than mine.
   — [Deactivated Member]

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