Hi! This is my first time on here..... I have gone through my pre-ops, did my medically monitored diets, I basically have everything in order. I just received the letter of approval for my surgery from my insurance, but it is for the wrong procedure. It was sent in for the sleeve, when I had talked to my surgeon about the bypass. I spoke to the office today and was informed that they cannot simply request a change, they will have to resubmit all of my information for my insurance to evaluate again. So I wanted to see if anyone had any experience like this, or any advice. I know it would be "easier" if I just accepted what I was approved for, but my surgeon highly recommended the bypass for me. And I have done a lot of reading and I agree it seems it would be optimal for me. There were a couple hiccups with my insurance initially because they couldn't find my psych eval, but once they had everything they approved me quickly. Which I am hoping happens again. My hope is of course that they will resubmitted and approve the correct procedure quickly. My fear is that it will cause confusion or complications because of the two different submissions. Any words of advice or experience would be greatly appreciated. Thank you so much, in advance.

Hi Christine,

I take it from your weight tracker that you must have gotten approved from Aetna. I just found out today from Aetna that I have been denied and that it's not covered. Was your WLS covered under your plan and if not what did you do to get approval?

Thanks,

Chris(cc583)

Did you get approved? How long did IEHP take and what was the full process?

I've in the same boat. I have Anthem (BC/BS) in Oklahoma, but have been told by customer service WLS is specifically excluded.   I verified this through two different WL surgeons.  One was a referral setup by Anthem.  It is really frustrating.  Did you ever get an answer?  Anthem is the only option I have through work unless I have military insurance. 

how does the hospital know? Is is an insurance requirement. 

Will insurance accept 2 years of recorded weight from anywhere? The recorded weight history is usually what the PCP does.