United Heathcare/Pacificare for Public Employees

MaMaMaRTiNeZz
on 11/15/11 7:03 am - Los Angeles, CA
RNY on 11/01/12

I have an HMO through UH and am currently under HealthCare Partners Network iPA Pasadena. When my Primary doctor requested approval for Bariatric surgery consultation is was approved immediately and I was sent to Association of South Bay Surgeons which is a HCP approved Bariatric Surery Facility. Even though it is about 1 hour from where I live, I travel to Torrance for my appointments with Surgeon and will be admitted to Torrance Memorial for my actual procedure. GB, Lap-Band, DS, and VSG are all covered 100% with NO deductible or copay under my insurance for either of these procedures. Revisions are also 100% covered. I am a Public Sector employee and I thank God everyday for my job because it has terrific benefits (I paid NOTHING to have my son via C-Section in a Top California Methodist Teaching Hospital with S-O-A Facilities). I am just wondering if anyone here has medical insurance due to being a County/State/Government employee and if the process to get approved for Gastric Bypass was smooth. I have a BMI of 45 which automatically qualifies me but I am also Pre-Diabetic with Asthma and a history of bone problems in my feet/ankles because of the weight. I have also been in my Bariatric Surgical Program since March 2010 and documented weight checks ranging from every week to every month or so, very consistent history of seeing the surgeon, nutritionist, nurse practicioner, and doing regular weigh-ins. Also, I have a regular schedule of seeing my Primary Care Physician for my co-morbidities as well. It has taken me almost 2 years being in this program to finally submit for authorization. I am hoping my history will give them enough info to approve me. Please let me know if anyone has similar insurance to me and what the process was like. Thanks :)

              NOTHING tastes as GOOD as SKINNY FEELS...

 Starting Pre-Op Weight: 305     Weight On Day of Surgery: 297 

  
          
                    

    

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