Recent Posts
Topic: I hate meritain
Im at 40ish days since my letter was submitted From all my contact with them its looking like it will be a denial I just wish they would get it over with already
once i get my letter i can know why there denying me and meet their needs for appeal
im really bummed
once i get my letter i can know why there denying me and meet their needs for appeal
im really bummed
Topic: RE: Florida Medicaid
Yes, straight Medicaid.... I've found out thy actually DON'T cover the DS :(
Topic: RE: Florida Medicaid
Hi as far as I know Medicaid accepts only the RNY ,,,they will denied the DS in a hart beat..,you have straight medicaid???
Topic: RE: Is this exclusion language?
Thanks for the advice. I spoke with my agent and its curious to note treatment for MO is required in my state. We are still going to check the policy though. I called and gave them the CPT codes and they said they required medical neccesity but could not tell me if they were an excluded service. I guess we will just have to file and see. Otherwise I will explore my self pay options.
Topic: Humana-KY state employee
Does anyone have any experience with this insurance? I am hoping to get the LapBand. Thanks!
Topic: Florida Medicaid
Does anyone know if FL Medicaid covers the DS (Duodenal Switch)??? I originally went to my surgeon for the DS but they told me I got approved for RNY and my insurance doesnt cover DS but I'm not too sure how true that is.... Even if it were true, I feel they should be able to appeal it and they are telling me NO.....
Topic: RE: Is this exclusion language?
I agree, those statements clearly state services related to obesity or mobid obesity are not covered.
I don't know much about obtaining coverage just check your options and work with your agent to get the best policy possible. :)
Good Luck!
I don't know much about obtaining coverage just check your options and work with your agent to get the best policy possible. :)
Good Luck!
Topic: RE: Aetna PPO - Thyroid Condition exclusion - Help?
Maybe our policies are different. That wording is the last bullet point in mine under all the loop holes you have to jump through to have surgery. I still don't know what to do about it. I am going to try to get the Dr. to write a letter to explain that the symptom of "modest weight gain" due to MH does NOT apply to me. I am really worried. Meeting with one Dr. tomorrow. Not meeting with the endocrinologist till Dec 1. I am also going to order MR as far back as 7 1/2 yrs ago to show it is no fluke thing. Fingers crossed I can convince them.
Topic: RE: Aetna PPO - Thyroid Condition exclusion - Help?
WAIT A MINUTE!!!! I have Aetna PPO and no were on my policy coverage information does it say this. I have hypothyroidism.
I am 27 years old, 5' and 3/4" tall. HW: 263 SW: 226 LW: 142 CW: 198
Topic: CareFirst of MD
The policy says a 6 month dr supervised diet, does anyone know if I show obesity or morbid obesity over a period of 10 years if that will suffice or will it just strengthen the case. Im starting the 6 month doctor supervised diet now but would rather just apply and see if I get approval. I've been over 300 lbs for 20 years and can prove it. any advice?

