Recent Posts
Topic: Nan 2008 and other aetna Vets
So i started my journey in august of this year, I did everything required and had my surgery date set for nov 21st, went to my pre op, got all my test done, and just when i think this nightmare is over and the office submited fir approval...,.......
I recieve a call from my doctors office telling me the visits with my Nut were too close together and they dont think they are gonna approve it unless i reschedule my surgery a week or 2 and do another visit. Well my mom is a flight attendant and for her to get that week off was hell, so i took the chance and told the office to submit and see what happens. If worst comes il just have to rechedule and have a lonely recovery. This sucks what can i do ??? is there a re sumbit timeframe for the paperwork if i get denied ??? will it be harder to get approved if i get denied??>> im really hoping the agent covering my claim is an idiot and doesnt notice lol . HELP!!!!!!
I recieve a call from my doctors office telling me the visits with my Nut were too close together and they dont think they are gonna approve it unless i reschedule my surgery a week or 2 and do another visit. Well my mom is a flight attendant and for her to get that week off was hell, so i took the chance and told the office to submit and see what happens. If worst comes il just have to rechedule and have a lonely recovery. This sucks what can i do ??? is there a re sumbit timeframe for the paperwork if i get denied ??? will it be harder to get approved if i get denied??>> im really hoping the agent covering my claim is an idiot and doesnt notice lol . HELP!!!!!!
God grant me with the serenity to accept the things i cannot change ; Courage to change the things that i can ; and the wisdom to know the difference!!!
Topic: RE: Appeal Tricare Prime C200odes 15830, 15832-50,15835
It is extremely difficult to get Tricare to cover plastics and usually only done under certain cir****tances. I know they will do a panni lift(not tummy tuck) if she is having rashes and so forth under the skin. As for a thigh lift, I honestly have not heard of them covering one.
Proud army wife and mom of 2 ♥ 
Topic: Aetna $15,000 lifetime max
Hi everyone,
It's been a long time since I posted in here, I gave up on my journey for a few years, but am finally working at an employer that provieds coverage for bariatic surgery! I have Aetna and it has a $15,000 lifetime maximum for bariatric surgery. I'm thinking lap band since that seems to be less expensive than Roux-en-Y and I don't have the money to cover the difference.
I've been looking around on here, and online, and I see so many varaitions of cost for the lap band. Do you think the $15,000 would be enough? From what I am reading it seems pretty easy to get approved, I will just probably have to do the 6 month diet with my doctor but I'm fine with doing that.
thanks in advance!
It's been a long time since I posted in here, I gave up on my journey for a few years, but am finally working at an employer that provieds coverage for bariatic surgery! I have Aetna and it has a $15,000 lifetime maximum for bariatric surgery. I'm thinking lap band since that seems to be less expensive than Roux-en-Y and I don't have the money to cover the difference.
I've been looking around on here, and online, and I see so many varaitions of cost for the lap band. Do you think the $15,000 would be enough? From what I am reading it seems pretty easy to get approved, I will just probably have to do the 6 month diet with my doctor but I'm fine with doing that.
thanks in advance!
"Nothing Tastes as good as being thin feels"
Topic: BC/BS PPO Michigan, Plastic Surgery
I need to change insurance because my current plan is no longer offered by my company.
I have had a high BMI (63), my RNY, and should need Plastic next summer.
Does anybody have experience with Blue Cross/Blue Shield of Mi PPO and do they typically cover plastic surgery ofter weight loose as medically necessary or cosmetic.
Thanks
I have had a high BMI (63), my RNY, and should need Plastic next summer.
Does anybody have experience with Blue Cross/Blue Shield of Mi PPO and do they typically cover plastic surgery ofter weight loose as medically necessary or cosmetic.
Thanks
(deactivated member)
on 11/6/11 1:18 am
on 11/6/11 1:18 am
Topic: RE: Crying need advice
There are several people on here who have posted about their denials and how they appealed. Even so far as to post their appeal letters that won them their approval. Check for them in the search bar. I am just sorry you are going thru it, and I will be praying for encouragment for you!! Good luck and keep us posted. GOD BLESS!!
Topic: RE: City of New York employee - Empire BCBS & GHI
Hi,
I see that you have reached your goal-CONGRATULATIONS!!! Also, I am a City of New York employee who also has GHI/BCBS and from your posts we appear to have very similar BMIs . I am still pre op but hope to have surgery very soon since i have completes all pre op testing and the 6 month weight monitoring. Any advice and/or experiences you can share are greatly needed and appreciated. I see you havent posted for some time but hope that you will see this post. THANKS IN ADVANCE!!!
I see that you have reached your goal-CONGRATULATIONS!!! Also, I am a City of New York employee who also has GHI/BCBS and from your posts we appear to have very similar BMIs . I am still pre op but hope to have surgery very soon since i have completes all pre op testing and the 6 month weight monitoring. Any advice and/or experiences you can share are greatly needed and appreciated. I see you havent posted for some time but hope that you will see this post. THANKS IN ADVANCE!!!
Topic: RE: Anyone have breast reduction with Tricare Prime?
Hey there, I had breast reduction surgery through Tricare Prime back in June 2008. My primary sent in the referral and Tricare approved it. I guess your Primary HAS to say it is medically necessary and state those conditions that you stated on your blog. They didn't even question it. Only thing was they didnt approve for the Surgeon that my PCP requested. They said he wasnt in the network. But they will let you know what percentage they will pay if you go to an out of network surgeon. Tricare paid for my RNY in June of this year. Good Luck! sharon
IN IT TO WIN IT!!!!!!!!!!!!!!!!!!
Topic: RE: BCBSTX
Not sure about TX but GA does not cover it so you will want to call them asap to make sure it's covered and start the process. your ins may not require a 6 month doctor supervised diet but if they do you obviously want to start it as soon as you can. Good luck
Topic: RE: approved - approved - approved!!!!!
OMG Congradulations! Please tell me what insurance you have! I have BCBSGA but I live in TN also. Do you have an idividual plan? I think I might have to purchase my own plan even though I can't really afford it...
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My insurance will not pay for my excess skin that hang down to my knees
Hockeymom87 · 0 replies · 731 views
Hockeymom87 · 0 replies · 731 views
