Recent Posts

Becca20015
on 3/21/11 11:30 am
Topic: RE: Has this happened to anyone?
I just wanted to say it will all work out.  I haven't been through this myself but hopefully all will get worked out.  Stay hopeful like you said.
slhobbs81
on 3/21/11 10:24 am, edited 3/21/11 10:28 am - Goldsboro, NC
Topic: RE: Good News!
That's awesome news!!! I'm so happy for you!

I'm trying to find a way to pay my high deductible. Who is financing your surgery?
(deactivated member)
on 3/21/11 6:58 am
Topic: Good News!
I'm so excited today I got approved for financing!  Now I can move forward with picking a date!

Jen
wantabeskinny2011
on 3/20/11 12:43 pm
Topic: Insurance????

My insurance doesn't cover any kind of bariatric surgery. I'm looking for a private pay insurance that covers vsg for my husband. Does anyone know of any private pay ins. that covers vsg? 

ToDream
on 3/20/11 2:38 am - Comox, Canada
Topic: Canadians? Any approvals??
I'm wondering if there's any Canucks on here that have any experience getting approved for WLS with their insurance provider, who they use and how they got approval?  I'd even hope my insurance would pay HALF!

Follow my Entire Journey at www.myaceinhand.blogspot.com

 

VSG April 25,2011   SW 223/ GW 135/ CW 135

WLS goal reached Feb 2012... now on to my body reconstruction Early 2014!!  

 

margaret3220
on 3/19/11 5:52 am - hermitage , TN
Topic: RE: Aetna / SRC
i have Aetna/SRc they cliam they want pay for the surgery.... i am still fighting with them over this its been a year later
Suite1
on 3/18/11 12:12 pm - Dayton, OH
Topic: Anthem & UHC refuse to cover me post op....

Anthem notified us we had to change from an employer sponsored plan to an individual or family one because my husband's company no longer has employees.   However, they are refusing to cover me now because I have "had bariatric surgery within five years".   United Health Care/Golden Rule rejected me for the same reason.    I have sailed through this process so far.  Had surgery on 9/14/10 and have had no complications.   I had a BMI of 41.3 and no co-morbidities when I started.   I've lost 98# and my BMI is now 27, and I'm 32# shy of my goal.   I take no medications and am healthier than ever.

I've gone to the Ohio  Dept of Insurance website to check into their high risk pool and even though they have a pretty lengthy and exhaustive list of pre-existing conditions, WLS is not considered to be one of them.   I'll call Monday to confirm.

In the meantime, I've written to a couple of the trade associations for bariatric surgeons to alert them to this possible trend.   

Has anyone else experienced this?    Any words of wisdom?

HW:  280  SW:  262.5  CW:  150
  GOAL!!!!   One week shy of my surgiversary!

     
LBL, TT, BA on 3/2/12 - Dr William Rigano  

Suite1
on 3/18/11 12:07 pm - Dayton, OH
Topic: RE: "Exclusion" -- is there any hope?
Exclusion means exclusion - no ifs, ands or butts about it.  Was told this by my family doctor who is on the medical review board and by the insurance coordinator in my surgeon's office. 

Ask your surgeon if they discount if you pay out of pocket.
HW:  280  SW:  262.5  CW:  150
  GOAL!!!!   One week shy of my surgiversary!

     
LBL, TT, BA on 3/2/12 - Dr William Rigano  

dildaydvm
on 3/18/11 8:28 am - Hillsboro, OR
Topic: RE: "Exclusion" -- is there any hope?
Hi there, thanks for your advice.  I'm definitely pulling for you and let me know the outcome.  As was suggested above, I reposted this question in the Roux-en-Y forum and got many responses...all of which were discouraging, however.  They all said that "exclusion" means no chance of coverage no matter what you do.  Apparently your EMPLOYER has the say as to whether or not WLS is covered or excluded, and since premiums are cheaper without it, most exclude it.  Sounds like the only option is to talk with your employer and convince them to cover it next year when the pollicy renews or to self-insure and shop for a pollicy that includes WLS.  As for me, I will be the new owner of my company in 15 months, so I'll have the fortunate priveledge of hand-choosing the pollicy when it's renewal time.  You can bet I won't exclude it!

Hang in there!
Mark
laurenac
on 3/18/11 12:51 am - Oklahoma City, OK
Topic: RE: "Exclusion" -- is there any hope?
Hi Mark, I am actually in the same position as you. In fact, I have the same exact coverage/plan as you. I asked customer service about the appeals process and she said to send letters from yourself and doctors to the address on the back of your ID card with attn to appeals. I am still feeling pretty defeated about it though.
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