Hi,

I am curious what you found out about the insurance. I am in the same boat and went through the whole process of getting ready and having the surgery scheduled when my insurance told me that due to a clerical error I actually did not have coverage. I am not giving up and determined that this is the right decision for me. I am actively searching for employers who offer this type of coverage. Any info you learned would be most helpful =) Amber

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So I have Anthem/Medi-cal. I have called anthem and they said they will cover any surgery as long as it is medically necessary,etc. I thought that was good news. As it turns out, while they will cover it, no surgeon will take me. i keep hearing how they aren't in my network or don't accept medi-cal. I was seeing a bariatric surgeon for a bit but then all of a sudden the hospital isn't contracted with my insurance anymore.

I can't self-pay as I am on disability. And I don't know what else to do! I've even called surgeons in other cities and again they don't take it! I am interested in the DS. I have doctors saying it's medically necessary.

Is there anything else I can do? Or am I just out of luck?

You will pay 618!

I'm going to have surgery on Dec. 12th and my insurance is Cigna. It is a PPO plan.  

I had the same conditions in having a 6 month medically approved weight loss program...having a BMI over 40, etc.  While I saw my  Primary Doctor at annual physicals and she had suggested diets in the past...her documentation wasn't good enough and I wasn't visiting her on a regular enough basis to have Cigna consider this as an approved weight loss program..  So....the weight loss/surgery center where I was interested in going for  bariatric surgery set me up on a program where I was seen by a Dietician, given a high protein diet to follow and then see her each month for six months.  I kept a journal of what I was eating, doing for physical activity, etc.  She would weigh me each month, tracking my progress.   When my 6 months was up....I had lost about 13 lbs., but was still obese with a high BMI.  Another requirement is to have a physological evaluation...something the center set up for me.  I met with the Physchologist for about 90 minutes for an evaluation.  She would then write up her evaluation in a report. With that completed, all of that, along with my physical information was submitted by the center to Cigna.   When submitted, it took about 2-3 weeks to get a reply.  The first time...they denied my submission.  They stated I needed to have a letter of authorization/acceptance from my Primary Care Physician.  Once my regular doctor wrote/sent the letter in noting my health issues and agreeing with my going forward with surgery, within 10 days I got an acceptance letter from Cigna.  (I have to say that overall Cigna was pretty helpful.  They were pretty clear about what the requirements were and I could call to get clarification or ask a question anytime.  I called once on a Sunday to find out the status of my submission and the Cust. Service person was able to tell me where it was and approximately how much more time it would take to go through review.  It's really a matter of dotting the i's and crossing the "t's"....you just have to know all those things up front...otherwise you can run into issues. )
My suggestion is to look for a surgery center that is a comprehensive weight loss center.  That way  they have the programs and staff that can handle all aspects of preparing for surgery, understand the insurance requirements and then follow-up and group meetings to help after surgery.     Good luck to you.....