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I have UHC and do not have a required non-surgical weight loss period. You might want to post this out on the main forum to see what others say. I am sure this concern is global, not just relevant to folks with UHC.
Sleeved 6/12/13 - 100 pounds lost to get to goal!
Thank you. That was very interesting to read. So maybe I have a chance to get approved.
I tried with Texas State Insurance and they wanted me to get a copy of a denial letter from Blue Cross Blue Shield, but i've been waiting on BCBS to send me that letter for 3 months.
Oh, I understand now - you have applied to get medical insurance, and you have been denied the actual insurance because of your weight. I thought you were denied the surgery by an insurance company you already have. My mistake, and I apologize.
I don't really know what to say. I don't know how to get an insurance company to cover you. The WLS's office likely wouldn't be able to help you out with this inquiry. I'm sorry. I would contact your state's department of insurance and see if they have any information they can give you.
I wish you luck.
HW: 274 | SW: 232 | CW: 137 | Goal: 145 (ticker includes a 42 pound loss pre-op) | Height: 5'4"
M1: -24 (205) | M2: -14 (191) | M3: -11 (180) | M4: -7 (173) | M5: -7 (166) | M6: -8 (158) | M7: -11 (147) | M8: -2 (145) | M9: -3 (142) | M10: -2 (140) | M11: -4 (136) | M12: -2 (134) | M13: -0 (134) | M14: -3 (131) | M15: +4 (135) | M16: +2 (137)
I don't have a policy as of yet. I'm self employed. I have tried BCBS so many times (individual policy) and they denied me. I had Humana 4 years ago. I spoke with them and they said they could probably get me approved, but highly doubt it.
Do you not have insurance right now? What about BCBS? You could certainly try, but as I said multiple times before, it really depends on each individual's policy. If you currently have insurance, you could go to a WL surgeon, and his/her insurance coordinator will look at your policy, contact your insurance company and determine what, if anything, you need to do to get WLS approved. If you don't currently have insurance (then I am confused based on your opening post), or you are in a position to change companies, it certainly couldn't hurt to try to ask the coordinator which company is best, but they might not tell you since, again, each policy is, in and of itself, different.
HW: 274 | SW: 232 | CW: 137 | Goal: 145 (ticker includes a 42 pound loss pre-op) | Height: 5'4"
M1: -24 (205) | M2: -14 (191) | M3: -11 (180) | M4: -7 (173) | M5: -7 (166) | M6: -8 (158) | M7: -11 (147) | M8: -2 (145) | M9: -3 (142) | M10: -2 (140) | M11: -4 (136) | M12: -2 (134) | M13: -0 (134) | M14: -3 (131) | M15: +4 (135) | M16: +2 (137)
So you are saying that if I go to a WL surgeon, an insurance coordinator can help me determine which insurance would be better suited for me?
Google is your friend.
HW: 274 | SW: 232 | CW: 137 | Goal: 145 (ticker includes a 42 pound loss pre-op) | Height: 5'4"
M1: -24 (205) | M2: -14 (191) | M3: -11 (180) | M4: -7 (173) | M5: -7 (166) | M6: -8 (158) | M7: -11 (147) | M8: -2 (145) | M9: -3 (142) | M10: -2 (140) | M11: -4 (136) | M12: -2 (134) | M13: -0 (134) | M14: -3 (131) | M15: +4 (135) | M16: +2 (137)
I have Aetna, but even different people within Aetna have different policies.
Your insurance company will likely have the requirement for a doctor-supervised diet prior to surgery approval. Alternatively, your surgeon might have his own requirement. For instance, one of the top surgeons here has a requirement that all his patients participate in a specific diet-class-exercise regimen/program prior to surgery. This could also be used to meet the insurance requirement. However, some of his patients have done the insurance requirement first, on their own, and it was not a strict enough program, so the surgeon made them do it all over again.
If you go to a consult, likely the surgeon's office will have an insurance coordinator on staff who knows the ins and outs of what is specifically required for you. And then they can help you navigate those waters. Good luck. It can be a frustrating journey, yet so worth it.
HW: 274 | SW: 232 | CW: 137 | Goal: 145 (ticker includes a 42 pound loss pre-op) | Height: 5'4"
M1: -24 (205) | M2: -14 (191) | M3: -11 (180) | M4: -7 (173) | M5: -7 (166) | M6: -8 (158) | M7: -11 (147) | M8: -2 (145) | M9: -3 (142) | M10: -2 (140) | M11: -4 (136) | M12: -2 (134) | M13: -0 (134) | M14: -3 (131) | M15: +4 (135) | M16: +2 (137)
Which insurance company do you use? Would the insurance company require for me to be on a six month diet or would that come from a nutritionist? My PCP referred me to a nutritionist but i don't know how long that would be.
Hockeymom87 · 0 replies · 818 views
