Recent Posts

MelodyMay
on 8/29/15 8:37 pm
RNY on 03/01/16
Topic: RE: Interqual guidelines for surgery

Something like a record of your weight loss attempts with Weigh****chers..something documented to show you have attempted weight loss before. 

Melody

HW: 394 SW: 359 GW: 187

    

MelodyMay
on 8/29/15 8:34 pm
RNY on 03/01/16
Topic: Change in Insurance

I have to leave Aetna for at least 6 months (didn't fulfill my hourly requirement thru my job) I was told COBRA would keep everything the same but I am finding myself stumbling from one road block to another and was hoping someone could tell me if there is an insurance company that only requires the 2 week liquid diet or something less time consuming than Aetna.

Figured, if I am being forced to change insurance companies, maybe I can find one that won't make me wait so long or won't require a PCP to sign off on it too.

Any info you have would be helpful. 


Thanks!

Melody

HW: 394 SW: 359 GW: 187

    

MelodyMay
on 8/28/15 2:02 pm
RNY on 03/01/16
Topic: PCP required?!

I have never had insurance for long periods of time. I hardly ever went to the Doctor as a child and as an adult the insurance coverage was always spotty or non-existent. My current insurance provider Aetna, said I needed PCP records but my surgeon said not to worry about it. I haven't had a PCP in at least a decade. Now I am seeing other posts where the Insurance was denied because of lack of records.

Is there anyway to be approved w/o 3 months of Primary Care Physician records?  

Melody

HW: 394 SW: 359 GW: 187

    

MelodyMay
on 8/28/15 1:59 pm
RNY on 03/01/16
Topic: RE: Insurance denying - Need records I can't come up with

Oh no! Now I am scared. I don't even have a PCP because I never had continuous insurance before. Am I doing all of this for nothing too? God, I hope not. I hope everything works out for you. 

Melody

HW: 394 SW: 359 GW: 187

    

MaronitaMay
on 8/21/15 12:55 am
Topic: RE: Psych Evaluation and Insurance

I've not had that issue but as someone who used to work at a health insurance call center, I've seen things like this work out for people by arguing that you went to a contracted WLS doctor and that you did NOT choose the clinician for the psyche evaluation and therefore THEY should cover it.  I would recommend that if they do not want to cover it to inform them you would like to appeal and ask whether they have an appeal process if so go through that, if NOT or you have exhausted the health insurance companies appeal process then you have a right to appeal to your states Dept. of Insurance.

 

sae761
on 8/15/15 2:35 pm
Meganthestylist
on 8/8/15 12:30 pm - Redlands, CA
Topic: RE: IEHP/medi-cal help/ self pay options? So lost.

I got an approval letter from iehp to see a surgeon yesterday. :)

hollykim
on 8/7/15 4:57 am, edited 8/7/15 4:58 am - Nashville, TN
Revision on 03/18/15
Topic: RE: 12 month supervised weightloss?
On August 6, 2015 at 1:54 PM Pacific Time, sayjay14 wrote:

I received information from my insurance today and they require a 12 month continuous medically supervised weight loss programs. I've seen 3, 6, and even 9 month requirements but 12 months?! Anyone else encounter this and how did you deal with this situation? 

some ppl have met the 12 month req. by having seen their doctor regularly when diet and exercise was discussed. 

The ppl who haven't had the dr visits,just had to start with month  one and do it for a year to qualify.

there is also self pay,if you are able.

 


          

 

sayjay14
on 8/6/15 1:54 pm
Topic: 12 month supervised weightloss?

I received information from my insurance today and they require a 12 month continuous medically supervised weight loss programs. I've seen 3, 6, and even 9 month requirements but 12 months?! Anyone else encounter this and how did you deal with this situation? 

Ann C.
on 8/2/15 11:03 pm
Topic: Medicaid of North Carolina - Who will accept this plan?

So, I have been on the fence for about 10 years and I seem to only continue to be yo-yo-ing and I want to be here for my son, its just us... However, things have changed drastically financially.  So I find myself on Medicaid in NC.  I went to REX's info Session at the end of 2014 and at that time they were saying that they accept Medicaid.  Went to my appointment a month ago only to be told that they do not!

So I registered for an info session with WakeMed; only to find out the same thing. 

Is there anyone that has been able to use Medicaid here in Wake County or near?  I am desperate and this was my goal for 2015... I'm not giving up, but I was hoping maybe someone here may know something or have used the plan.

 

Ann

Ann C.



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