Question for SHBP Members

LaShelle2
on 9/7/11 1:20 am - STOCKBRIDGE, GA
Has anyone received an answer on whether the state will pay for your follow up care 2012 and beyond?


What about:

band fills
port slippage, flip, erosoin
emergency revisions
tpn or vitamin tranfusions
feeding tubes
stricture
annual labs and follow up visits

If you have surgery for example 12-30-11 will it cover the follow up?

Is it just ending coverage for the actual surgery procedure, or any treatment related to the surgery?


People seem to have taken the position "well I got mine,  so I'm covered, and I don't have time to deal with anyone else"  But, is  that really true? Could this effect you too even if you are a post op?
These are things we need to know.

If anyone can gert clearance on this, please share so I can pass it along to my support group.

               **** I AM AN OH SUPPORT GROUP LEADER ****
WHY I CHOSE DS: 
No dumping.  Highest percentage of weight loss, Best long term results,  Won't regain weight!  Eat normal sized meals,  96% diabeties, 90% high blood pressure, 80% sleep apnea cured.                                    I  MY DS!
My doctor told me to stop having intimate dinners for four unless there were three other people.    ~Orson Wells  

Member Services
on 9/9/11 4:27 am - Irvine, CA
Hello LaShelle2,

Check out our post below:

http://www.obesityhelp.com/forums/GA/4448465/Use-YOUR-Voice- OH-needs-YOU/

Thanks,
Member Services Department
shbowen
on 9/14/11 4:34 am - GA
According to the UHC website, this is what is says...

The Bariatric Resource Services (BRS) benefit is being eliminated by the State Health Benefit effective January 1, 2012.  No new patients are being accepted into the program for the remainder of 2011.  

All pre-surgery requirements and scheduled surgeries must be completed by December 31, 2011.  If the member has already  registered with BRS, they should contact their assigned BRS Nurse at 800-955-7976, ext. 72908 with any questions.  A BRS staff member will contact the member within 48 hrs.

Lap-Band adjustments:  If the member has had a previous lap-band surgery and develops complications requiring an adjustment, then the lap-band adjustment will be covered.

LaShelle2
on 9/15/11 7:28 am - STOCKBRIDGE, GA
That's good!

I wonder what Cigna is doing?
undergoingchange
on 10/10/11 2:48 am
I just read this post today.  I have CIgna.  They require 6 month supervised diet and exercise before they will allow surgery.  They cover RNY and Lap band.  Not sure about GS.  I only checked in to the other two.
delightful74
on 10/10/11 1:04 pm - Fairburn, GA
Yes, but if you are not on the table before or on December 31st, 2011, your surgery will not be covered by insurance. I think Lashelle was asking about the doctor's visits, etc. for those of us who have had the surgery. I think this is unfortunate for the state employees that started the process and won't be finished in time. The state plan did also cover DS and VSG (I think), however none of them will be covered in 2012.
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