Need Your Opinion

Sweetish
on 2/17/14 2:00 pm
RNY on 12/12/14

I am just getting started in my journey to hopefully have WLS this year.  I contacted my insurance and asked them for a copy of the bariatric portion of my policy, specifically the weight loss surgery section of it.  They sent me a copy and it did say that I needed to complete 6 consecutive months of supervised weight loss program that needs to be done through my PCP and a Nutritionist.  I called them once also and asked them what I needed to do for approval and they said basically the same thing.  My surgeon's office called today and told me that they spoke to my insurance company and they were told that I didn't need to do the 6 months before applying for surgery.  Does anyone have any suggestions on what I should do?  I am so confused now.  

HKFandora
on 2/19/14 7:47 am

I'm in the same boat. My insurance said (the rep I spoke to) did not see a mention of six months. It angers me because I'm a revision and if I don't need to wait I won't. I too asked them for written section regarding bariactrics and they sent me some handbook with no info! Frustrating. 

Sweetish
on 2/20/14 3:33 am
RNY on 12/12/14

Hmmm, that is so weird.  Do you have BC/BS?  I can view my policy online.  Can you do that?  I wonder if you contacted your HR Dept. at work if they can send you the full written portion of your policy, (just the weight loss portion)?  Let me know if you find something out, can you?  I am very confused on who to believe.  Since my posting I have contacted the insurance rep. that works for the surgeon so she can check.  Sometimes they know how to word things to your insurance company.  That may be a good idea too.

56sunShine14
on 4/10/14 8:26 am

I too am hoping for revision and my apt is next week to meet the surgeon.  I have BC/BS and my policy is online also.  However, the only thing that is said about bariatric surgery is that they will only cover 50% IF the revision is medically necessary.  They will also cover 50% to take down the lap band.  I guess I will call them and see what they say.

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