Insurance Question

mturner71
on 4/12/08 7:02 am - Anderson , IN
Hi, I'm Mallory. I'm new to the forums here and I have a couple questions. First off, I'll tell you a little about myself. I'm 21 years old, 5'6" and 284lbs. I want to have the laproscopic RNY procedure done. I am currently uninsured, but in the process of signing up for the Healthy Indiana Plan (HIP). Is anyone currently insured by this or have any information regarding gastric bypass and this plan? (i.e. Is the procedure covered by it?) Also, I've been looking for supported doctors/hospitals and I can't seem to find any that I am familiar with. I live in Anderson, so the only hospitals that I really know are Community and St. Johns. I'm guessing I will have to travel to Indianapolis, which is fine. Can anyone recommend doctors or hospitals there? Any other information or suggestions would be great! Thanks in advance!
Jessica S.
on 4/12/08 7:41 am - Noblesville, IN
Welcome Mallory!  You'll find this a pretty friendly and helpful group of losers. Most of us here have had, or are planning, surgery at either St. V Carmel or Clarian North ... although some have gone through Community and St. Francis.  I personally recommend Dr. Jones, Dr. Gupta, Dr. Cacucci and my own surgeon, Dr. Evanson.  (I think pretty much everyone will sing the praises of their chosen surgeon!) I did some searching of the HIP web sites.  It looks like the Anthem BC/BS plan specifically excludes all bariatric surgeries!  I couldn't find specific information about the MDWise program ... but I wouldn't be surprised if it's similar to the other plan.  You might want to discuss coverage for surgery with member support at the HIP program offices so you know for sure. 
mturner71
on 4/12/08 10:57 am - Anderson , IN
Really? It's good I found out before I submitted the paperwork, I actually chose Anthem because they covered me when I was younger. Thanks for letting me know! I'll call the MDWise/HIP people on Monday and ask them. I've been hesitant to bring up bariatric surgery because I thought it might throw up a red flag and compromise my acceptance to that particular insurance company. If neither company covers WLS, can anyone recommend one that does? I'm on limited income at the moment, which is why I was trying to get insured through a government program. I'm new at this whole insurance thing, my mom took care of it until I moved out, so I'm not too familiar with what questions to ask or how to even find a decent company. Thanks
Jessica S.
on 4/12/08 12:53 pm - Noblesville, IN
Many insurance companies have their "Members Handbook" online, and that's usually where you can find what's included and what's excluded.  Of course, there's a lot of legal lingo that says the lists are not the final say, the insurance company always has the right to decide what is and isn't covered, yada yada yada.  The Anthem BC/BS member book is linked on this page: http://www.anthem.com/wps/portal/enp/ath?GROUP_NAME=HealthyIndiana The MDWise one is here: http://www.mdwise.org/HIP/members/
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