I'll try to make this breif and not confusing so bare with me lol

Me and my husband recently finally got jobs *yay* and my husband is going to get BCBS of Alabama for our family (him, me and our son)

I have been wanting to get gastric bypass and so now I am finally taking the steps on seeing a doctor and get this ball rolling. But I was just wondering with my husband just now getting the insurance September 2010 would this cause any problems of trying to have the surgery in 2011?

Yes, I called two Ins companies.  One will call me back.  The one that did answer said that it IS an exclusion and will prevent them from writing you.

However, if you already have a policy they cannot cancel you, so you can keep it.

 I was told that they take ATLEAST 30 days to approve, but then heard that they work pretty fast... does anyone have any experience with Illinois medicaid? I know all states are different so thats why I'm asking about Illinois. 

 Guess what!  I decided to mess around on the insurance co's website.  I clicked on the Provider tab, then clicked on Manual and Policies, Surgeries.  Eureka!!!  There it was in black and white.  See if you might find something similar on your insurance co's website.

Here is the sample letter from NAN2008,  changed it around to fit my cir****tances and took it to my PCP to sign it. The Surgeon faxed it to Cigna Insurance Monday Aug 30, and as approved Friday Sept 3rd!!!  I am sooooo excited, I hope this letter help you as much as it helped me. God luck.



 January 01, 2009   
RE:     Patient’s name 
DOB:    

To Whom It May Concern:   

This letter is in support of bariatric surgery for xxxxx xxxxxx.. She has had a life long struggle with obesity and has attempted numerous methods of weight management without lasting results for over xx years that she has been a patient with us. She has tried various weight loss methods, including Weigh****chers, Atkins, Richards Simmons, Liquid Protein shakes, Adipex, Slim Fast, Diet Center, Protein Power and the 6-Week Body Makeover. She has lost significant amounts of weight on some of these programs, only to gain it back each time. She has exercised in the past, including exercise tapes, walking on a treadmill, and following a cardio and strength training program. She has a strong family history of obesity, hypertension, Type II diabetes, and heart disease. At this time, xxxx is extremely committed to pursuing bariatric surgery.  xxxxxx has been diagnosed with morbid obesity, along with co-morbidities of Osteoarthritis of the knees and Hypertension. 

Her current weight is xxx pounds and height of x’x". Her BMI is xx. In the past couple of years her weight has fluctuated between xxx and xxx pounds in our office.     I believe that xxxxxxx is extremely motivated and knowledgeable about bariatric surgery and committed to making this a lifelong change. Her ideal body weight and weight loss goal is approximately xxx pounds. She is currently taking no medications and has no known drug allergies.   

xxxxxx began a 3 month multidisciplinary surgical preparatory regimen on xxxxx xx, 2008. She has been in compliance with all components of the program and at this time, I feel that she has exhausted all of the options available to her other than weight loss surgery. I find this surgery to be a medical necessity and have referred her to xxxxx xxxxxxxxx, M.D., who specializes in laparoscopic Roux-en-Y gastric bypass surgery and offers extensive pre and post operative follow-up care.    Should you have any questions regarding this recommendation, please feel free to contact me directly.   

Sincerely, 

Xxxxxxx   xxxxxxxxxxxxx, M.D.    
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