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Topic: RE: BCBS Federal - Revision for Light Weight
I would check it out also. I had the rny and have gained back quite a bit of weight. I wish I had researched it better. I didn't know about many surgeries then.
Topic: RE: Feeling Forced to Finance
I was self-employed when I had my surgery. I can't say how things work now, but I got some info off this site about 8 years ago. Every insurance company has an open enrollment month when they pretty much have to take patients they normally wouldn't. I asked the person in the surgeons office that takes care of these things which insurance company I had the best chance with and they told me anthym blue cross, blue shield. I called them and got the information I needed to get approved. Then when It was time for their open enrollment, I sent the money and application. I had to pay over $700 per month and pay ahead but I was approved the first time the surgeon sent in the request. I didn't really have much in the way of co-morbities. My surgeon told me that it's all in the way you write the letter. I didn't see the letter, so I don't know what he said. but it was worth the money it cost. I couldn't get any insurance any other way, I tried. No one would take me.
Theresa
Theresa
Topic: Denied new health ins. policy bc of past WLS
So, this is probably not the usual issue posted about on this forum, but here goes...
I left my job about 2 weeks ago to prepare for going back to school full time. I was in the midst of getting an individual policy for myself and my family to cover the time while I'm in school until I get a job after graduation. After answering all the health history questions (truthfully), I was transferred to the underwriter. She proceeded to tell me that Humana declines to cover people who have had WLS in the past. Now, the insurance I had through my job was with Humana. My policy had an exclusion for WLS, so I paid out of pocket. I'm at my wits' end because I must have health insurance as a nursing student, plus we've got a 3 year old who needs to be covered too. I don't really want to do COBRA because of the high cost, but will do it if I don't have any other options. My husband and daughter could be on a policy by themselves if I have to resort to COBRA.
Does anyone know of a health insurance company that will do an individual policy for someone like me who had WLS in the past? There's got to be one out there somewhere. I'm in Kentucky if that matters.
I left my job about 2 weeks ago to prepare for going back to school full time. I was in the midst of getting an individual policy for myself and my family to cover the time while I'm in school until I get a job after graduation. After answering all the health history questions (truthfully), I was transferred to the underwriter. She proceeded to tell me that Humana declines to cover people who have had WLS in the past. Now, the insurance I had through my job was with Humana. My policy had an exclusion for WLS, so I paid out of pocket. I'm at my wits' end because I must have health insurance as a nursing student, plus we've got a 3 year old who needs to be covered too. I don't really want to do COBRA because of the high cost, but will do it if I don't have any other options. My husband and daughter could be on a policy by themselves if I have to resort to COBRA.
Does anyone know of a health insurance company that will do an individual policy for someone like me who had WLS in the past? There's got to be one out there somewhere. I'm in Kentucky if that matters.
Topic: University of Texas health insurance - UnitedHealthCare Choice Plus
Does anyone have any experience with this insurance? i will continue to be a graduate student at the university until august, and am considering paying the 300 for the policy, but i don't think it'll be worth it if it doesn't cover WLS, since i already have a "free" one from work that excludes WLS.
I'd appreciate any help on the lingo if possible! I can't seem to tell whether it covers WLS. It seems to say that it covers stuff that is "medically necessary", but then has weight loss treatments, etc. as exclusions.
I can email you the insurance brochure if you'd be able to provide me with any insight. I've been morbidly obese for the last 28+ years and I've felt defeated all my life by my weight...this gives me a tiny bit of hope until I can confirm whether it covers it or not.
I'd appreciate any help on the lingo if possible! I can't seem to tell whether it covers WLS. It seems to say that it covers stuff that is "medically necessary", but then has weight loss treatments, etc. as exclusions.
I can email you the insurance brochure if you'd be able to provide me with any insight. I've been morbidly obese for the last 28+ years and I've felt defeated all my life by my weight...this gives me a tiny bit of hope until I can confirm whether it covers it or not.
Topic: RE: BCBS 24 visits....so discouraging
Thanks a lot Rebecca.
Yes, that 24 visits was a long time. The only way I would have been approved by BCSBS would have been my PCP appealing on my behave, but you know how some doctors are. He was taking his own sweet time, and I never heard from him regarding the matter. So with when I spoke with the surgeon's office, she informed me that Medicaid in Illinois is more laid back regarding approval, virtually you only need your physician's recommendation, I would get approved. BCBS was my primary and Medicaid was my supplemental, and I had my employer drop me from BCBS and and now Medicaid is my primary and now I have appointment tomorrow with my surgeon. I am so excited. Hold on, cuz a change is coming.
Thanks for the wishes and good luck to you too dear. Keep me posted on you progress as I will do the same.
Yes, that 24 visits was a long time. The only way I would have been approved by BCSBS would have been my PCP appealing on my behave, but you know how some doctors are. He was taking his own sweet time, and I never heard from him regarding the matter. So with when I spoke with the surgeon's office, she informed me that Medicaid in Illinois is more laid back regarding approval, virtually you only need your physician's recommendation, I would get approved. BCBS was my primary and Medicaid was my supplemental, and I had my employer drop me from BCBS and and now Medicaid is my primary and now I have appointment tomorrow with my surgeon. I am so excited. Hold on, cuz a change is coming.
Thanks for the wishes and good luck to you too dear. Keep me posted on you progress as I will do the same.
Topic: RE: BCBS 24 visits....so discouraging
Thanks a lot Rebecca.
Yes, that 24 visits was a long time. The only way I would have been approved by BCSBS would have been my PCP appealing on my behave, but you know how some doctors are. He was taking his own sweet time, and I never heard from him regarding the matter. So with when I spoke with the surgeon's office, she informed me that Medicaid in Illinois is more laid back regarding approval, virtually you only need your physician's recommendation, I would get approved. BCBS was my primary and Medicaid was my supplemental, and I had my employer drop me from BCBS and and now Medicaid is my primary and now I have appointment tomorrow with my surgeon. I am so excited. Hold on, cuz a change is coming.
Thanks for the wishes and good luck to you too dear. Keep me posted on you progress as I will do the same.
Yes, that 24 visits was a long time. The only way I would have been approved by BCSBS would have been my PCP appealing on my behave, but you know how some doctors are. He was taking his own sweet time, and I never heard from him regarding the matter. So with when I spoke with the surgeon's office, she informed me that Medicaid in Illinois is more laid back regarding approval, virtually you only need your physician's recommendation, I would get approved. BCBS was my primary and Medicaid was my supplemental, and I had my employer drop me from BCBS and and now Medicaid is my primary and now I have appointment tomorrow with my surgeon. I am so excited. Hold on, cuz a change is coming.
Thanks for the wishes and good luck to you too dear. Keep me posted on you progress as I will do the same.
Topic: RE: Did you have to appeal to have the VSG?
A BMI of over 50 for the VSG? Or is it the same for any wls? I was approved for VSG with my first application with a BMI of 44. I wish I could help but I've never heard of that! Good luck.
Topic: RE: BCBS 24 visits....so discouraging
24 months? That's a really long time. My insurance required 6 months and I know people here (in Arizona) who've had wls with medicaid and they had to wait 6 months too and jump through lots of other hoops, but 24 months seems like so long. Do you have problems that could justify your doctor asking for an exception?
I don't have much advice but to say I'm so sorry. I do understand. I had insurance that I did all the preop stuff (cardiologist, pulmonologist, nutritionist, blood work, psych eval, 6 months of doctor supervised visits) and then was dropped right before we submitted. I was hysterical. Now, a year and half later with new insurance, I am scheduled for April 27. Good luck to you! I really wish you the best.
~Rebecca
Mother to 4, married to a wonderful man, trying to find myself again.
Mother to 4, married to a wonderful man, trying to find myself again.
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