Recent Posts

noftessa0401
on 12/6/12 2:39 am - San Diego, CA
RNY on 12/27/12
Topic: RE: revision

Sorry no one has answered you yet.  It really depends on your insurance.  Did they pay for the first one?  Some policies exclude any and all WLS, and some are a once-per-lifetime type of policy.  Some cover revisions if medically necessary.  And it will depend on the reason for the revision - you might have to show that the revision is needed NOT due to your failure to follow post-surgery instructions.

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)

noftessa0401
on 12/6/12 2:36 am - San Diego, CA
RNY on 12/27/12
Topic: RE: Keep Getting Denials for Insurance

Meaning that your BMI is not high enough?  Can I ask what it is?  Do you have co-morbidities?   Have you submitted for pre-approval, or has your surgeon's office submitted?  Have you had a consult with a surgeon yet? 

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)

RNfatty
on 12/3/12 12:04 pm
Topic: RE: best insurance company

I own my own small business and have been told by my insurance agent that none of the individual or small business plans will cover it. I'm not willing to give up that easily. I know that BC/BS of LA will not cover ANYTHING related to obesity (as I see patients and have been denied payment if I write obesity on the bill). But I also have patients with UHC, Aetna, Humana, to name a few who have been able to get bariatric surgery.  So keep looking and keep asking, I know I will.

SickofBeingThisWay
on 12/3/12 10:16 am - Dallas, TX
Topic: Keep Getting Denials for Insurance

Hi everyone. I am new to ObesityHelp. I have been denied insurance over and over and over again because of my weight and height. It is IMPOSSIBLE to pay for WLS out of my pocket, and now i'm at the point of not knowing what to do or just giving up? Have anyone ever felt this way or ever had this happened to them? cool

 

 

Signed

 

Angry and Upset Obese Diva

ChelseyKay
on 12/3/12 6:30 am - NE
Topic: best insurance company

Im looking VERY hard for an insurance company that I can get as an individual, not through my employer, to cover the DS. I am eager, but frustrated with this process, as im NOT winning....anybody have any imput or experiences? PLEASE?!?!

serenity1959
on 12/3/12 4:33 am
VSG on 08/05/13
Topic: RE: Insurance won't cover so I need $25,000

Is that a Bariatric Center of Excellence?

chunkymonkey1991
on 11/29/12 4:10 am
Topic: revision

I had a VSG a year and a half ago and may need a revision. Does insurance cover it?

Please visit my blog at chunkymonkey6491.blogspot.com  
  
anna9905
on 11/27/12 7:41 am - GA
Topic: BCBS of Alabama

I have BCBS of Alabama.  I was soooooo shocked to find out  today that I got my approval after only three days after submitting it to them (and one of those days was Thanksgiving! lol).  I am so excited but nervous!  Just happy to finally have an approval because I was afraid they would deny me the first time.

Gemmie02
on 11/25/12 9:42 pm
Topic: RE: Tricare Prime
I'm with BCBS of New Mexico and they haven't given me any problems. My Dr said Tricare prime (at least here in NM) won't cover it. I also have Tricare standard and hope they'll cover the surgery as a supplemental insurance.
mlhutz625
on 11/25/12 7:17 am
Topic: UHC- HELP!?

Hi,

I was hoping someone can help me, I am fulfilling my requirements to receive the lap band. I started back in May 2012 and have been denied 3 times (appealing) since I haven't had six months documented weight loss. This will be my last month for a weigh in and I am just getting very nervous because I lost weight 5 out of the sixth months. One month I did gain weight, due to the wonderful things women go through. I am really nervous that I am going to get denied I am trying so hard and have been really struggling, it is not coming off easily and not staying off easily.

I guess what I am trying to ask, has anyone gone through the six month process and gained weight but got approved or denied?

I am 21 years old and have been dealing with weight since I was 9. My BMI is way over 40!

Thank you for any advice or help in advance!

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