Recent Posts
I'm newly on Medicaid and I'm checking into the possibility of WLS. I've already looked through the forums and checked with the only one I was able to find that looked like they would do it, DR. Dominguiz in Covington, but the patient advocate said he only does it for patients in Saint Tammany or Washington parishes which sucks because I'm in North East Louisiana.
Guys, I'm over 400 pounds and I feel like I'm at the end of my rope as far as weight loss goes.
If any of you know of anyone else I can check with please please PLEASE help me.
I have Anthem Healthkeepers through my job but they do not cover any obesity surgery. I have been to a seminar and called a local surgeons office. The visit is over $230 and the surgery is quoted at $15,000. I am currently considering CareCredit, GoFundMe, a WLSFA grant, or charity care through the hospital. I do have a BMI of 65 and several Co-morbidities. Any suggestions or advice about what kind of next steps to take would be appreciated. Thank you!
visit a bariatric clinic and ask them what plans they accept. When I went for the introduction seminar I found out my insurance at the time didn't cover it ... but they had a list of all the insurance plans they did take ... so I waited for the next enrollment period 9 months later and switched. 8 months after that I finished the required appointments and tests and got approved, my surgery was a month after that.
Im currently going to Loyola medical center to get a bypass-revision, my medicare insurance is Aetna better health i have to go for six months don't gain weight, andi have to keep a log of my eating and exercise and submit it to the nutritionist every month... what did they say the reasons were for non-compliance?
Hello, I'm new to this but I have so many questions if anybody can please help ? Well I have IEHP, and I've had to do 6 months of weigh****chers and I've had to check in with my primary doc once a month, I didn't do good @ weigh****chers I gained and I lost, can that be a problem? My consultation with a Bariatric Doctor has also been approved.. They gave me an appointment to attend an informational seminar first, mailed me paper work to take for that day and said after that seminer I would get to have a "face to face" lol appointment with the Doctor SO.... Does any of this sound familiar to anybody??? If so what should I expect next? Will the 6 months of weigh****chers (and being supervised by my doctor) be enough? And how long will it take for me to finally get my lapband surgery?
Hello I'm looking to have surgery and I've been denied twice. My bmi is 43 and I did the physicians path and I have sever sleep Apnea and prediabetic but they said it's not a medical necessity. Would you be willing to help me too...
Hi how did it go.. did you get approved???? without having to submit the 5 year documentation. I just finished my 6 months today. And tomorrow my Pcp is going to submit the referral.
on 12/28/16 9:08 am
Does anyone know what percentage or amount of weightloss is considered "compliant" in order to get a revision? I was non-compliant and am working on weightloss with the band although I have never had any significant success with it. I have been denied for a revision due to non-compliance
Hello, I have BCBS of MN and I am jumping thru the hoops for insurance now. I made my own appt with a bariatric surgeon on Sept 21, at that appointment I spoke with the surgeon's nurse, the surgeon, and I was also introduced to a patient advocate who takes care of everything. My insurance requires the same thing as yours and this is what I had to do.
I had to have an Appt with a nutritionist and a psych evaluation (both set up by the advocate) both have to approve you for surgery.
I had to make an appointment every month for 6 months with my primary care physician and weigh in and talk about dieting, exercise etc. Because I had met with my PCP in August and we spoke about diet and exercise and she put it in my chart this counted as my first monthly session. I have my last session on Jan 5 and after that they ( bariatric nurse or advocate) will send paperwork to insurance and I wait for approval.
Once I am approved I then have to take some nutrition classes (3) and then they can schedule my surgery.
If you have any questions feel free to ask I will help if I can.

Tammy
HW: (9/28/16) 369.8 / SW: (3/13/17) 285 / CW: 162.8
Pre-op loss (6 1/2 Months) - 84.8 pounds
M1 - 17.2, M2 - 17.2, M3 - 13.4, M4 - 15.4, M5 - 13.8, M6 - 13.6, M7 - 10.8, M8 - 9.6, M9 - 5.0, M10 - 2.4, M11 - 3.8
Hi everyone,
This is the answer I received from my insurance company. Is there any point in appealing this? I feel it is a pretty solid answer. Anyone run into this and then got approved? I did a search and they are all a couple of years old. I have Anthem BCBS.



