Recent Posts

Heleena33
on 6/17/11 1:03 pm - Custer, WA
Topic: Self Pay?
So, if you pay yourself, do they still make you wait a long time?
Helene
beth-28
on 6/17/11 10:42 am
Topic: RE: United health care choice plus???
From what I understand, and I am not an expert, it isn't UHC as much as it is your employer. If your employer chooses a policy with WLS coverage, then it is covered as long as you meet their requirements. My husband works for a company that chose a UHC policy that included WLS. The conditions I have to meet are a BMI of 40 or over, or a BMI 35-39 with at least one co-morbidity...High Cholesterol, Sleep Apnea, High Blood Pressure...etc. I have a BMI of 40.1 with Diabetes type 2, andHigh Blood Pressure. So I meet their requirements. If your friend has a husband, have him check his insurance policy, or have her talk to her HR department and see if they have any intentions of maybe changing policies some time soon. Best of luck to her.
When push comes to shove....shove hard!

       

Never regret anything, because at one time it was exactly what you wanted.

(deactivated member)
on 6/17/11 8:50 am - east falmouth, MA
Topic: RE: Fed BCBS
 I had a very easy time getting Blue cross to approve... My bmi was 43 ... don't worry yet!
Newme.1
on 6/16/11 1:57 pm
Topic: RE: Insurance Denied Me!!! Please help with any suggestions!!!
Call your insurance company daily, ask what else is needed, keep on your surgeon office to appeal and resubmit.  PERSISTANCE gets the job done and alot of it comes from the patient.  I kept getting the same runaround and called and would get 2-3 different answers in the same day.  I think they finally knew I was serious and was not giving up and finally approved me and now I am 5 weeks out and it was worth every phone call.  Good luck.
    
Ann M.
on 6/16/11 1:43 am - GA
Topic: XP: Pre-existing Condition Insurance Program (PCIP)
I saw this and thought about those who are struggling to get their after care who are uninsured. For those that are pre-op I couldn't find the benefits so I don't know if it covers WLS. You have to have a pre-existing condition or been denied because of a medical condition (hello- obesity!) and have been without health insurance for 6 months. HTH

Typically, the people who are eligible are under age 65 and have no employer group health insurance. They have too mu*****ome to qualify for Medicaid and are not yet eligible for Medicare. And, they have not been able to buy an individual health insurance policy because of a health condition.

 

To be eligible, a person must:

 

  • Be a US citizen or legal resident;
  • Have been without health insurance for at least six (6) months; and
  • Have a pre-existing condition or have been denied health coverage because of a health condition.

 

If you want to know more about the specific plans in a State, visit www.pcip.gov or call toll-free 1-866-717-5826 (TTY 1-866-561-1604).

 

Thank you for helping us spread the word about this new insurance plan. 

 

 

Are you uninsured?   Do you have a medical condition?   If so, you may be eligible for the new Pre-existing Condition Insurance Plan.  Call toll-free (866) 717-5826, TTY (866) 561-1604 or visit www.pcip.gov and click on “Find Your State" to learn more.

 

-Band to DS revision on 06/21/2011!
Highest known Wt/ Lowest Wt (Banded)/ Regain-Starting Wt/ Current Wt/ Goal Wt
379.6/ 272/ 342/ 169/ South of 200

 

Newme.1
on 6/14/11 5:34 am
Topic: Anyone!
Had my surgery, went great, doing great.  I also had hernia repair and gallbladder removed at same time and since those surgeries pay different the hospital lumped my total hospital bill under weight loss surgery only so paying every surgery as a weight loss surgery.  Has anyone else had this?  This is costing me about 10,000 dollars more the way they have this coded.  Hospital states they cannot itemize services and has to go under primary dx even though I knew and planned on having the other 2 surgeries at same time.  ( My insurance only pays 60% of WLS and no out of pocket max and does not apply to deductible.)  Any help with this would be greatly appreciated.  I already called insurance , hospital and surgeon office and the said this is the way its done.  
    
Shelly S.
on 6/13/11 8:31 am - Stillwater, OK
VSG on 12/13/12
Topic: RE: The Sleeve and Medicare
Medicare approved my LapBand surgery with no problem. Don't know about the sleeve, when I had my surgery in '08 Medicare only covered Lapband and RNY.

Shelly

 

    

    
Diminishing Dawn
on 6/11/11 10:28 pm - Windsor, Canada
Topic: RE: Ontario Health Insurance Plan
You should get a call fro
The centre within a few months generally and start the process. Message me anytime for more info and visit the ontario board on ohh

17+ years post op RNY. first year blog here or My LongTimer blog. Tummy Tuck Dr. Matic 2014 -Ohip funded panni Windsor WLS support group.message me anytime!
HW:290 LW:139 RW: 167 CW: 139

ladyjae
on 6/10/11 2:18 am
Topic: RE: United health care choice plus???
I used UHC-It paid for everything-This was in 2005, tho, & I did hear recently they were getting picky about coverage-Definitely let the dr insurance person help-Mine was wonderful-Hope this helps-Jae
ima_ford_gurl
on 6/8/11 12:39 pm
Topic: United health care choice plus???
THIS QUESTION IS FOR A FRIEND ANY ADVICE WOULD BE APPRECIATED!!! She sent this to me thats why its written the way it is!

I have united health care choice plus. I called them the other day and to ask if they covered WLS and they told me no, but on here Ive read several people being approved with UHC choice plus. I know other people who have UHC and it always seemed we had the better policy compared to my friends. I am wondering if there would be a better chance of them covering it if the doctors office called the insurance company? I have several medical things caused by obesity. Just looking for some advice.
Thanks
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