Question:
Do you need your primary care doctor referral to have the surgery done?

Have talked to my doctor on the phone and she told me I would not be approved without her referral.    — Debbie C (posted on February 13, 2004)

February 13, 2004
Not necessarily true. It depends on your insurance coverage (EPO/PPO) plan and their requirements. Check out the benefits manual or go online if they ahve a website. I did not get a referral and was fine. However in recent months when I wanted to go see a Plastic Surgeon I was REQUIRED to have a referral. I guess it depends on how picky the insurance wants to be as well.
   — SassySamara

February 13, 2004
For my insurance BCBS/PPO I had to have one from my family Doctor(referal), Physc.(clearance), pulminary Doctor(sleep apnea) and a heart Doctor(stress test),WLS Surgeon too of course, plus I had to get proof of all the diet pills and WL programs I have done. Took 5mo to get cleared, but it was worth it! Good luck!
   — Sandy M.

February 13, 2004
I don't know if it is necessary, but I asked my primary physician her opinion on the procedure. I was prepared to hear "it's to risky, you should try something else, etc." I was surprised when she said "I think you would benefit from this" Then I ASKED her to write me a referral (I had already done my homework on who did surgeries in our area - and knew what dr. I wanted to go to and why). I told her about who I wanted to see and explained why - and she wrote me a wonderful referral letter to take with me when I went. I have to think that it can not hurt to have TWO drs (primary and WLS surgeon) opinions when it comes to the insurance approval.
   — Allee Z.

February 14, 2004
It depends on your ins. my pcp did not talk very favorable when I vaguly mentioned it to him. i didn't even tell him I was going to have it. I didn't need a referral so I just picked up the phone and called the surgeon of my choice and he started the ball rolling. My pcp found out several months after the fact.
   — Delores S.

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