These days more and more insurance companies are covering bariatric surgery.  Of course, that's not to say they won't make you jump through some hoops to get it.  But, w/ your height/weight you should not have problems qualifiying from a BMI standpoint.  I am a federal employee w/ Aetna, and they cover lap band, VSG, RNY.  A friend of mine, also a federal employee, has BCBS and she said they approved her lap band without hesitation.  Probably your best bet is to shop around by going on various websites of insurance companies and seeing what they cover.  Or give them a call and actually talk to a human to see what is covered, what the prerequisites are, if there is any waiting period...stuff like that.  I think you might be surprised to see what is available.  Good luck to you!

The wonderful team at Dr. Heiders office requested approval for the VSG last Friday afternoon, and Monday afternoon they called me with an approval, from BCBSNC.  My surgery date is set for August 11th!!! 

 

Has anyone else dealt with CIGNA?  I am working on getting together the information for the weight management program.  The clinic I am working with wants it to have consecutive 6 months.  The policy states it needs to be at least 6 months without significate gaps.  The Clinic says that CIGNA is very strict with this portion of the requirements.  When I speak with CIGNA, they tell me to still with what the policy states.  They do not really have a definition of significate gaps.  Also, the clinic wants more data then what is stated in the policy.  The policy asks for weight, diet and exercise.  Calling CIGNA and they say that is all they need.  But again the clinic is telling me they need very detailed information such as notes on discussions (with the doctor and noted by the doctor) on why I am overweight, what triggers eating and so on.  The clinic keeps trying to get me to start a new 6 month program with one of their people. 

So...do we think that the benefits people at the clinic know what they are talking about or do the people at CIGNA? 

Has anyone else worked with getting their surgery approved through CIGNA?

I have AETNA, and worked closely with the insurance coordinator at my surgeon's office.  She indicated that AETNA usually responds very quickly - within a week.   The three-month option is also OK as long as it is done with the nutritionist at the surgeon's office.  I'm going self-pay because I haven't had a consistent  BMI greater than 35 for two years. (I'm a yo-yo dieter)  The insurance coordinator states that AETNA is very picky about that unless your co-morbidities are quite severe. 

The clinical policy bulletin spells out all the requirements quite clearly, and it's available on the AETNA website.

Good Luck

I have been debating the idea of weight loss surgery, and after MONTHS of research, I have settled on the Lap Band procedure. I recently turned 26 and my coverage with my father's insurance company has ended. It is seemingly impossible to find an insurance company that covers it. Any suggestions. I am 26 years old, I'm 5'5" and I weigh 334 pounds. Please HELP!!

Thank you!