Recent Posts

nayttap
on 11/4/13 10:03 am
Topic: RE: Anyone file for/receive SSDI for co-morbidities?

I doubt that those comorbidities qualify....otherwise we'd all qualify.  In our obese society, who'd work to pay the taxes to  support all of us?

HW:  275;  CW: 155;  GW: 120-135;   Ht:  5'2"

Lap Band 8/2011

Revision to VSG 12/2013

    
Bluffdalian
on 11/3/13 2:51 am
Topic: RE: Anyone file for/receive SSDI for co-morbidities?
Not to sound harsh but you do realize that all federal programs are supported by me, you and other tax paying people? Why can't you work throughout your journey like thousands of others do instead of looking for a handout? I don't pay taxes so you can stay home and "concentrate" on losing wt.
PNGmom
on 10/31/13 6:25 am - Port Neches, TX
Topic: RE: Insurance question
I called yesterday and they told me the same. The lady I talked to said 15 business days. My surgeon office sent over my stuff they requested on the 18 the of Oct. This waiting is driving me crazy. But maybe since we having got denied yet it's a good sign. Hope we both here real soon. I'll keep you posted. Thanks
ABath
on 10/31/13 5:58 am - WI
VSG on 11/26/13
Topic: RE: Insurance question

Just wanted to let you know that the Customer Service rep at Aetna told me they have 15 calendar days from the date they received ALL of the information. If your surgeon turns in your paperwork and then a week later Aetna asks for additional info, they then have 15 calendar days from the date they upload the info into your file (there could be a delay from when they receive to when they upload). Ugh!!!

 Height: 5'1" HW: 229 SW: 203 CW: 147.7

       

    
hollykim
on 10/30/13 11:30 am - Nashville, TN
Revision on 03/18/15
Topic: RE: Cigna - Denied
If it isn't stated in your insurance policy,the insurance can't require it. I would all and speak to a supervisor and ask them politely to tell you exactly what page paragraph ans item that requires a Pcp letter.

If they can't Tell you exactly where to find it ,I would demand that I. Be approved right that. Minute. .
If it is a surgeon requirement that is a different matter. It has to. Be in clear understandable writing in your policy or they can't insist on it.

 


          

 

pharmagirl_45
on 10/30/13 3:51 am - NJ
VSG on 01/14/14 with
Topic: RE: Examples of "organized weight loss program"?

Some insurance companies allow WW, but I don't beleive myfitnesspal will work.  They will also take a certified nutrionist or your family doctor if you see they once a month for six months.

     VSG on 1/14/14 with Dr. Samuel Wasser

    

    
beautyfromash
on 10/29/13 11:45 am
Topic: Examples of "organized weight loss program"?

UHC states

Patient must be enrolled in and have participated in an organized weight loss program for a period of at least six months prior to surgery. The weight loss program does not have to be physician directed.  Does myfitnesspal.com count?  Or does it have to be like WW, TOPS, etc?  Anybody know?
ABath
on 10/28/13 2:11 am - WI
VSG on 11/26/13
Topic: RE: Insurance question

I still don't have my approval and it was submitted on the 14th. I have been calling either every other day or every day. They told me that they have 15 days after they receive ALL of the information they need. Since my surgeon's nurse faxed over additional info on the 21st but they didn't upload it to my file until Thursday, the 24th, my 15 days starts over on the 24th. 

I went through this process 2 years ago and needed an additional 5 months of documented weight (but put it off due to my divorce). They sent me a rejection within 7 days that time so I'm trying to be positive that the longer weight means a better chance of an approval since they didn't deny it outright.

I found out that the surgeon's nurse did not send my 2012 stuff over and I'm nervous because my bmi was 39.7. The nurse told me when she finally sent it in last Monday that she would write a bmi of 40 since it rounds up to that but Aetna is very picky and I know that some people have been rejected for a bmi of 39.9. I also wrote a letter letting them know that I was going through a divorce during that time and was skipping meals due to stress. I was also on a diet but my weight spiked again as soon as I stopped skipping meals. Hopefuly that will help.

Keep calling and asking. Good luck - let me know how things turn out.

 Height: 5'1" HW: 229 SW: 203 CW: 147.7

       

    
PNGmom
on 10/28/13 1:52 am - Port Neches, TX
Topic: RE: Insurance question

ABath-just checking in with you to see if you heard anything yet? I am getting kinda of nervous the longer they make me wait.

 

BelieveInFaith
on 10/26/13 11:07 am, edited 10/26/13 11:08 am - NJ
RNY on 08/08/13
Topic: RE: For the people 6 month required weight loss for BCBS... I have questions for you

Your six month requirement must be with an MD.  My pcp did not do this but my surgeon did so that worked out.  Also you can find physicians who do weight loss programs and stick with that for 6 months.  My bc/bs is with PA.  The insurance will go by your first weigh in with the doctor. So just be aware what the insurance requires your bmi to be at to qualify. 

Never accept NO for an answer.

 

        
Most Active
×