Recent Posts
Topic: Premera Heritage Plus 1
Hello, I have Premera blue cross in washington state, I just found out that my benefits have a written exclusion for obesity related surgery, prescriptions, etc. Am I dead in the water as far as having them pay for this, or is there some way I can proceed and see what happens before I decide to self pay?
Im currently 27 years old and just under 500lbs, I don't think medical necessity or etc is going to be an issue, just wondering if I have options or if "thats that" on this.
Im currently 27 years old and just under 500lbs, I don't think medical necessity or etc is going to be an issue, just wondering if I have options or if "thats that" on this.
Topic: RE: Too much weight loss during pre-surgery diet??
I have Aetna and they will look at a two year history of your BMI. Myself and my three kids all were approved with Aetna. You must show a two year history and within those two years can not dip below the 40 or they will deny. But once you start the process, they go from your startinig weight.
BTW, you can see their clinical bulletin at www.aetna.com. Then, in the search box type 0157 and it will bring up clinical bulletin 0157 which is their requirements for bariatric surgery. or type in bariatric surgery in the search box and it will bring up clinical bulletin 0175.
Good Luck with your approva!
Nan
BTW, you can see their clinical bulletin at www.aetna.com. Then, in the search box type 0157 and it will bring up clinical bulletin 0157 which is their requirements for bariatric surgery. or type in bariatric surgery in the search box and it will bring up clinical bulletin 0175.
Good Luck with your approva!
Nan
Nan
HW 300 / SW 280 / CW 138 / GW 140
Hit Goal 4/2/2010
Topic: RE: Financing?
Hi,
Just a note, please reconsider having lapband surgery. There are so many people who have had a lot of problems with their lapbands and had to have them removed. I would like you to read a little more about "Sleeve" WLS instead. It is a faster way to lose weight, and much safe for you. And yes there are places that do finance WLS. If you have any questions please feel free to ask me any questions that you have. If you read much on this board you will see where so many people have what they call a revision--having their lapband removed and having sleeve surgery. I once thought about having lapband surgery until I educated my self and found out it wasn't what I wanted. I am so very happy that I had sleeve WLS instead.
Hugs and take care
Just a note, please reconsider having lapband surgery. There are so many people who have had a lot of problems with their lapbands and had to have them removed. I would like you to read a little more about "Sleeve" WLS instead. It is a faster way to lose weight, and much safe for you. And yes there are places that do finance WLS. If you have any questions please feel free to ask me any questions that you have. If you read much on this board you will see where so many people have what they call a revision--having their lapband removed and having sleeve surgery. I once thought about having lapband surgery until I educated my self and found out it wasn't what I wanted. I am so very happy that I had sleeve WLS instead.
Hugs and take care
Suzanne B
Eugene, OR
Dr. Aceves
10/21/2008
Start lbs 225
Now 120
Eugene, OR
Dr. Aceves
10/21/2008
Start lbs 225
Now 120
Topic: Have you found your WLS doctor yet?
Hi,
I know that finding the right doctor for your weight loss surgery is hard sometimes, when there are so many choices. I was a self pay patient, so I looked at many doctors.
Please do not pick a doctor because of the price he is willing to do the surgery for.
Make sure that you are having the surgery done in a full hospital and NOT a clinic. Check this doctor out and read everything there is to read about them. Ask how many days they keep you in the hospital before they send you home. Check and see how many surgeries that the docotor has done that you are going to have. For me I had sleeve surgery and I wanted to know how many successful surgeries my doctor had done and if they he any surgeries that the patient experienced a leak?
This is your body and your life and you have the right to know all these things. If you would like any recommendations please contact me. But all the things I have listed are important for you to know before you put your life in their hands.
I know that finding the right doctor for your weight loss surgery is hard sometimes, when there are so many choices. I was a self pay patient, so I looked at many doctors.
Please do not pick a doctor because of the price he is willing to do the surgery for.
Make sure that you are having the surgery done in a full hospital and NOT a clinic. Check this doctor out and read everything there is to read about them. Ask how many days they keep you in the hospital before they send you home. Check and see how many surgeries that the docotor has done that you are going to have. For me I had sleeve surgery and I wanted to know how many successful surgeries my doctor had done and if they he any surgeries that the patient experienced a leak?
This is your body and your life and you have the right to know all these things. If you would like any recommendations please contact me. But all the things I have listed are important for you to know before you put your life in their hands.
Suzanne B
Eugene, OR
Dr. Aceves
10/21/2008
Start lbs 225
Now 120
Eugene, OR
Dr. Aceves
10/21/2008
Start lbs 225
Now 120
Topic: RE: Medi-Cal???
No waiting list at all, once I decided on the surgery I wanted they sent in the paperwork, four days later I was approved and then my surgery was scheduled three weeks from that date (gotta leave two weeks for the liquid diet and another week to set up child care and time off work and such) It was very prompt.
Height 5'8" Highest Weight - 245 Surgery Weight - 220 Goal Weight - 150-160 Current Weight - 155
Topic: RE: Too much weight loss during pre-surgery diet??
Aetna will use your beginning BMI not the BMI after your supervised diet
Topic: RE: Too much weight loss during pre-surgery diet??
Thank you Danny! That is good advice. I don't think I can see my complete policy online, but I will try to get my hands on a hard copy!!
Topic: RE: Too much weight loss during pre-surgery diet??
Can you check your insurance policy online, or do you have a hard copy? I have BCBS and it specifically states that the starting BMI is the one they sure for predetermination.
-Danny
-Danny
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