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Some of you are familiar with my story.
2008 - Lap Band - Did not find sweet spot, gained back my weight. Had a Hiatal Hernia with acid reflux. BCBS Federal did approve this surgery. Dr. Timothy Eldridge
2009 - Removal of LB and revision to a different bariatric surgery VSG. - Did not reach my weight loss goal. Hiatal Hernia has enlarged and acid reflux worse. BCBS Federal did approve the Removal of the LB, but Denied the VSG, had pay cash. Dr Toby Broussard
2013 - Was denied for Revision to a different bariatric surgery (RNY) - Because of not being in compliance with the 2 previous surgeries. Dr. Luis Gorospe
2014 - Planning on Revision to different bariatric surgery (RNY). On my 3 month program right now. Dr. Lana Nelson
Anyone out there having a 3rd chance of surgery covered from BCBS Federal or whoever? Yes, I checked read and understood BCBS Federal medical policy and they do cover revision to different bariatric surgery.
Please share your story. Thanks everyone!
Babygirlinokc
Virgie Tschirhart
Lap Band - 2008, Sleeve - 2009, RYN - 2017
Started Program Weight July 13, 2017 - 194.2
Before Surgery Weight December 27, 2017 - 185.0
Current Weight - February 2018 - 161.0
Are there any Geico employees out there who can fill me in on some of the insurance requirements? Back when the plan was BlueCross, we were told we needed to be with Geico for five years before the would pay for WLS. Since we were switched over to United Healthcare Choice Plus this year, I'm hoping there has been a change to this policy. We've been employed for three years now...I really don't want to wait two more years for surgery! Any tips?
I believe you need to call your husband's insurance and ask them if they will accept it.
Hello everyone!
I have just landed a new job and am wondering if there is anyone here that resides in Michigan and has Aetna Choice POS II insurance. It is a PPO, so I will not have to jump through hoops trying to get referred to a specialist, but I am wondering if anyone has been able to get the by-pass utilizing this type of insurance. Since I am being allowed to choose, I want to choose the insurance that will cover the surgery. My BMI is 62 so I know I am medically eligible so the only thing now is lining up with the right insurance.
Thanks!
MsPhyl
just got a referral to see about bariatric surgeon. I really want to have the gastric sleeve done. Has anyone got this approved with Tricare?
I've pretty much given up on IEHP, I got my cosmetology license last Friday and I've already had a few interviews this week. So it looks like I'm going to be looking into some sort of self pay option, the hours I'll be working in a salon just don't give the flexibility to play the go to x amount of doctors this week based on when the insurance company says to go game. Hopefully this all works out.
Well who knows there are a lot of people who interpret that differently. I would get the records and submit them anyways. You have nothing to lose by trying, and appealing the decision. I see no reason that it would make any difference where the physician is located to document your weight. Unless you have only lived in your current state for just a month... On the other hand I don't have insurance coverage for bariatrics and I paid out of pocket, it sure was nice not to jump through all the insurance hoops to get the surgery. I'm assuming you have gotten some kind of medical certification... which choosing your place of employment for the insurance coverage would greatly benefit you. Especially jobs with or funded by the city, county, state, or federal, or a large company. These are the kind of places that will likely have the best bariatric coverage. Maybe your supervised weight loss will already apply to the new plan? Good luck!
Outpatient VSG 9/5/14
with Dr. Umbach in Henderson NV
They sent a letter stating I was denied because I do not have records showing I've been overweight the last 5 years. I called them and explained I have been living in Oregon the last 6 years and I could have records sent over since I have in fact been overweight for 12 years. The lady on the phone told me that would not work, my records would have to be from this state over a 5 year period.
Can you help m. I am at my 2nd level appeal with BCBS Anthem... Although I don't have the same doctor I need the revision surgery to RNY...PLEASE HELP...MAYBE A COPY OF YOUR APPEAL LETTER..Hi I have Anthem, and the CPT CODE my doctors office used Anthem is saying it's considered Investigational/Experimental... I was wondering if you still had a copy of your1st or 2nd Appeal letter OR IF you could offer any suggestions on how I can get approved....I have a dilated Stoma, Gerd, Reflux, HBP. Lower back problems, my BMI meets the requirements...Also this is for a Revision to RNY...I APPRECIATED ANYTHING YOU CAN HELP WITH.
Hockeymom87 · 0 replies · 858 views
