How long did it take to get approved by your insurance?

I have heard that it has taken up to 8 months?

What is an average time frame?

Thanks!

Hi there,

Many times it depends on what type of insurance you have.  I had Blue Shield HMO and my approval was very fast, within a month after all my pre-op stuff was done.

Barb

Once I had all the required testing and the surgeons office submitted for approval it took about 10 days. I had called my insurance a few months ago because I was scared that I would be denied, they told me that as long as the Dr puts that it is medically necessary that I would be approved. All insurance companies are different and have different requirements that will take them longer to approve. I wish you all the best on getting your approval.

Dawn

I was fortunate and within a few weeks I had approval first time around.  Part of it is where you are at physically, and I have a BMI of 54, just about super mobid obesity.  I think it may have contributed to the quick approval.

Thanks guys!

I have Cigna.

My BMI is 53, but I have no other problems and I take no medication.

Hopefully it will be a fast approval.

From beginning to end it was 14 months.

Once I switched insurance to a PPO it was only 3 months.
My HMO sucked and was a huge roadblock in the journey. My PCP said the famous eat less move more WLS is smoke adn mirrors. SO I fired him. Then they would only reffer me to a WLS surgeon who didn't do VSG and there was no other options IMO. I had to fight for the referral to a Dr that did all surgical options.
Then one day the skies opena dn the heaven smiled on me adn I got a badass job with kickass benefits and switched to a PPO. From then on the process was fast the and easy. I had to wait 30 days for them to kick in, once they did I got everything done in 2 months, Dr submitted paperwork and I was approved in 9 days. It was long hard fight most of the way but worth every second of it.

 

MInd you that was almost 2 years ago now adn the VSG is easier to get approved adn more widely accepted as a WLS option by insurance compaies.

I actually just did the the same but with the opposite effect.

On january 1st I changed over from HMO to a PPO. And then I realized that The PPO won't cover the WLS but the HMO would have covered it.

So right now I'm waiting for january1st 2010 to come around so I can change back to HMO again to have the WLS covered.

With the HMO, can I pick the surgeon for the WLS or do I  have to use the one they tell me to?

Do you mean just for insurance approval, or the whole process from beginning to actual surgery?

Well, actually I would like to know both.

I would like to have surgery as soon as possible.

I actually decided to have surgery 1 year ago. But then gave myself 1 year to try and loose weight in other ways.

And now that I already waited 1 year and failed in my attempts to loose weight. I realized that my current insurance won't cover the WLS. So I have to wait another year before I can change back to the HMO that will cover WLS.

But if approval will take another year, that means that the earliest that I can have the surgery is 2 years from now.

And I REALLY don't want to wait that long.

The process doesn't take that long IF your insurance company isn't giving you the run around.

My process wasaround 7 months from start to finish, including a 2-3 month "slow down" when I was a little unsure. Here's how it went down:

Oct/Nov 2007 -- First got interested in WLS.  in Oct/Nov 07. I was really "gung ho" and wanted to do it.

Nov/Dec 2007 -- First consults w/doctors, psych eval, nutrition appt, abdominal ultrasound. Had to meet with the weight management doctor first, who helps you decide whether you are a candidate for surgery or if you are going to a medically managed weight loss program (food in a box--which I *knew* was not for me!)

Early Jan 2008 -- Took required pre-op surgery class. Hadn't decided yet for sure if I wanted RNY           or Lapband (the only two that this surgeon's office offers.) Also went to a support group as I wanted to meet real live human beings who'd had WLS and had lived to tell about it. The idea of surgery scared me a little bit as I'd never had any surgery before, plus, I'm kinda  squeamish.

mid-Jan-March 2008 -- Things slowed down a bit because I got a little scared. Still had to do a few  pre-op tests but I dragged my feet, didn't even schedule them.

April/May 2008 -- Got back on track, scheduled and completed the rest of the tests.

Late May 2008 -- Decided to switch to a different surgeon who kinda works "with" the original surgery group, but technically has a different practice, so I had to submit all my info to the new surgeon. Fortunately, this didn't slow things down at all, as far as I can tell.

Wednesday, June 5, 2008 -- First meeting w/new surgeon. Told him I'd already done the whole process w/the other surgery group and he said he'd accept all their evaluations--no problem, and that I should be able to have surgery pretty soon. Insurance paperwork was submitted to ins. company sometime between Wed June 4 -Fri June 6, 2008

Fri Jun 6 and Mon Jun 9-Wed June 11, 2008 -- I called insurance company several times. First to confirm they got the request, and then later to ask them if they could possibly review it ASAP. I explained that I live 3000 miles from my parents (my only family) and that there was a surgery date available on Fri, June 13 and that my parents (both doctors) would be able to come out to be with me during surgery on that date. However, if not, I would have to go through it alone because, being MDs, it can be hard for them to "wiggle" their vacation schedules. At some point during this time I went to the hospital to do all the paperwork "just in case".

Wed, June 11, 2008
--Early AM -- got a call from lady at ins. co. whom I'd been speaking with--she told me she'd tried her best to ask the department that reviews surgery requests to do mine ASAP, but that she 't think that they would not even be able to review it in time for Friday, let alone approve it in time for me to have surgery.
-- 8:30AM. Did all pre-surgery testing (EKG, chest X-ray, blood tests) w/internist in the hopes that I could actually have surgery on Fri, June 13.
-- Around 9:30 am, walking out of doctor's office, got a call from surgeon's office--I'm approved! Surgery on Friday!
--Two seconds after I got off the phone w/surgeon's office--called my mom--told her "OMG, I'm approved." She got off the phone and made flight arrangements for herself and my step-dad to fly out same day.
Wednesday late evening--parents arrive in California (they are saints, what can I say?)

Friday, June 13, 2008--Surgery (got out of hospital Sunday the 15th--Father's Day)

Thurs June 20, 2008 -- "Changing of the Guard" Mom/step-dad fly home in morning, my dad flew in that night to take care of me (either because he's my dad or because he's a doctor, he felt the need to be out here to help me recover--he didn't think I would be able to be alone that soon after surgery). Spent nice weekend with dad. I felt fine (though tired) so we went to see Wicked, went for a walk on the beach, out to lunch in Malibu (I had soup!), etc.

Bottom line--things *can* go pretty fast! Don't worry that it will take a year!