Recent Posts

nursemichele613
on 1/17/12 4:09 pm - MI
VSG on 04/22/12
Topic: RE: Has anyone written their own letter?
Hi Nan!

   I am currently attempting to get approval for the sleeve. I am hoping to put a letter together as well! Could you please PM the letter you wrote so I could use it as a sample? Thanks so much in advance! I want to get this ball rolling!! :)

           Michele
matdeb85
on 1/15/12 10:18 pm
Topic: Anthem BC/BS of NH -Insurance Nightmare Just starting
I am a little over three years post lap band. After two years my band slipped, Anthem paid for this fix without and issue. Sevens months later a severe infection was found treated but returned. This happened four times before the figured out my band was infected, my doctor said I easily could have died. So in April of 2011 I had to have the band removed and I can not even begin to explain what this did to me, I cried for days. I had just spent over two years getting to the point with my weight that I was thrilled. My surgeon told me after six months we could do a sleeve. She thought that since it was a revision and I had been so sick that the approval should have been easy......well as I am sure you can guess it is not. First off, for some reason the reviewing doctor apparently did not read my record as his decision was bases on the fact that my BMI was to small to be even considered for weight loss surgery. He somehow completely missed that original surgery and that this pre-authorization was for a revision. I am hoping my surgeon can get this straightened out but if not has anyone any advice for dealing with Anthem? Has anyone been successful in an appeal with them?
MikesJulie
on 1/14/12 11:53 pm, edited 1/15/12 6:39 am - MA
RNY on 02/07/12
Topic: BCBS MASSACHUSETTS

Good Morning

i was wondering..for all of you who have have/had BCBC of MA..how long did it take for the insurance company to approve your surgery (Roux en Y)?  i am asking  because as of tomorrow i am done with all of my appoinments including medical clearance and I am so anxious

Julie

AngelNichole
on 1/13/12 5:13 am, edited 1/13/12 5:13 am - OH
RNY on 02/21/12
Topic: RE: Need info on financing WLS in Mexico!!
He didnt specify but...I have heard good things about dr joya In mexico

Linda B.
on 1/12/12 2:45 pm - CO
VSG on 09/13/12
Topic: trying to qualify with kaiser
First of all, I'm new. I've been lurking since I found this site after my husband had VSG on 12/9. I was searching for unflavored protein, and found this wonderful group of people.

After some of the classes and seminars DH had to attend to get his surgery, I decided it might be a good thing for me as well. Trouble is, my PCP at Kaiser says my BMI is not high enough. I'm about a 37-38, have HBP and a scarey family history. Almost all the women on my mom's side of the family wiegh 300+, I'm always between 215-220. I have tried many diets and can usually get rid of 20 pounds, but no more, and it always comes back. Even after explaining this to PCP, he says I don't meet Kaiser's guidlines.

My DH's surgeon suggested I start by getting a sleep test (I snore) and if that comes back clear to write a letter stating my case to PCP and even higher up if needed.

So, now that you have some background, does anyone have any suggestions? I should hear back about the sleep study soon. If I have sleep apnea, I could potentially qualify. I am not in a huge hurry as DH's surgeon is in the reserves and is being deployed to Afghanastan and won't be back for a year. I figured it would take about that long to jump through all of Kaiser's hoops anyway.

Thanks,
Linda
Londa7
on 1/11/12 1:29 pm
DS on 07/10/13
Topic: RE: Need info on financing WLS in Mexico!!

Was your physician able to give you the names of these physicians?  I am sure if you don't do your reasearch re: surgeon, ( in ANY country) then you may possibly be taken advantage of.

Londa7        

                
AngelNichole
on 1/11/12 4:19 am - OH
RNY on 02/21/12
Topic: RE: Need info on financing WLS in Mexico!!
I have heard bad things about going to mexico for surgery..My surgeon told me that he had paitents who went to mexico for surgery and came back and didnt loose any weight only to find out the dr in mexico never actually did the procedure ..
Londa7
on 1/10/12 4:53 am
DS on 07/10/13
Topic: RE: Need info on financing WLS in Mexico!!
Since I haven't gotten any replies, I researched it myself and came up with a few sites that you may be interested in. American Healthcare Lending, Bliscompany.com, Medicalfinancing.com, e-financing-solutions, Med Loan finance.com, cosmeticredit.com. So far these are the only ones I have researched up to this point. I hope to use Dr Aceves for my WLS and Nina, his coordinator sent me the website www.medloanfinance.com as one of the companies that they use for their patieints. Good luck with your journey!!

Londa7        

                
josher_m
on 1/10/12 3:53 am
Topic: $5000 max lifetime benefit--is this doable??
So my insurance finally covers bariatric surgery but they have maximum lifetime amount of $5000.00.  I know insurance negoties rates with doctors but that seems awfully low.

When I checked into the surgery last year they said the cost was $28-29k so how can I found out realistically what insurance will cover?

My husband had gallbladder surgery and the cost was over $12k and insurance only paid $1k or something like that so I'd like to think this MIGHT actually be doable but it just seems so unbelievable.

Anyone have more info or can shed any light?

I'm waiting on dr's office to call me back and hoping they can provide more info but I always like to hear real life stories too.
(deactivated member)
on 1/10/12 2:05 am
Topic: covenrty ins
anyone have it? I live and work in Maryland and our new insurance is Covenrty of Delaware.
has anyone gotten approved for WLS with this insurance company?
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