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My primary insurance is Self Pay through my husband's employer and they have a specific exclusion for weightloss surgery. Medicare is my secondary and I know that it will cover a D/S.
I am trying to figure out a way to get my surgery paid for and if Medicare will pay if the "Medical Necessity" for my surgery to my primary insurance fails to provide a one off approval.
Presently I have a 56.5 BMI and a bunch of comorbidities, along with already having needed two spinal surgeries, one, most assuredly is due to my weight.
Has anyone had any luck with this?
Cheers,
RhainyC
HI, I know this is an old post but came across it. Was wondering did Tricare pay for your lap and to be put in? And what was the reason for the removal? And revision to bypass? I have Tricare prime and in process of trying yo get my band removal. Thanks for any info!
Hi MichiganGal, I too am from Michigan...I have reg Medicare part A and B, I also have full Medicaid with AARP for my prescription coverage. I had Gastric Bypass in 2000 which left me with a scar from my belly button to my breast bone. The muscles in my stomach were cut and therefore over the years and with weight gain have ballooned to the point of having this rather large upper stomach that sticks out. so my body consists of two rather large hanging muffin top's with a rash on and off between them. Do you have any idea if my insurance would pay to have a tummy tuck?
I'm getting rid of my band and switching to the sleeve. I'm using Tampa General Hospital because they accept Staywell.
I looked at my Florida BCBS policy and it has an exclusion for bariatric surgery. I went to an information session last night at a surgeon who I am researching, and his group provides details about which insurance companies they can work with, and what is required to submit for approval.
Maybe start there... find a surgeon, then find out what insurance companies they have had luck with. You wont find anything 100%, typically you have a dollar amount you have to reach before they cover stuff, such as $2500, then they cover 80%.
Look in to it some.
So I've recently been looking into getting gastric bypass surgery. My first concern is insurance. Calling around to the major insurance companies I keep getting shot down with, "Oh no ma'am. we don't cover ANY type of bariatric surgeries." I was wondering if anyone knew of any companies that would, under certain policies, cover gastric bypass surgery 100%?
call them and ask tobe sent a copy. If they give you the run around,tell them you KNOW,that by law,they. hAVE to provide you with a copy if you ask for it.
All of this paperwork is confusing me. I just got something from Atena re: my living will and the Power of Attorney. They are saying that the person with POA can't be in my living will. That, to me, is insane. My Fiancee is the one who is responsible for my POA if my sister isn't avail. But guess what, the POA can't be a blood relative either.
I don't know what to do. There are a total of 2 people who I literally would trust with my life and my belongings and they can't be my POA and/or be on my Living Will.
What am I supposed to do?
on 1/24/16 5:35 pm
I'm working on getting a copy of the actual policy right now. Every time I go to the website to look up my benefits, it says they aren't available. :(
Hockeymom87 · 0 replies · 808 views
