Recent Posts
My primary insurance (UHC) and Medicaid as secondary both had the same requirement of BMI of 40 and 6 months medically supervised weight loss program. This means you must have a record of a medically supervised diet for 6 months which means a record of being weighed every month for 6 months by a medical professional. In those 6 months, you must lose at least 10% of your body weight in order to get approved. If losing 10% means you fall below the required BMI for surgery, that is ok. They need to see you are motivated and willing to change your life. I contacted my insurance company in December. I started my program with the dietician in January at 250. I weighed 224 when the surgeon submitted to insurance and I was approved in 7 days. I was 217 on the day of surgery. 2 1/2 weeks post op I am 200. I was on the edge when they submitted to insurance too. I was told by my case manager with the insurance company that would not be a problem.
Maggie May
If Medicaid covers WLS in your state, they will pick up the out of pocket as long as you have met their pre-surgery requirements. For my state you need a BMI of over 40 w/comorbidity, a 6-month medically supervised weight loss program, psych eval, and referral from your doctor. My primary insurance only covers the hospital, not the surgeon's fees. Medicaid picked up what the primary didn't cover.
Maggie May
Our ObesityHelp Events are an amazing experience for you! With less than ONE MONTH go to, please join us for our 2013 ObesityHelp Conference in Anaheim, California on October 4th and October 5th for the time of your life.
Straight from our members that have attended an ObesityHelp Event.....
Every surgeon is different. It's best to give the office a call and they'll let you know. Goodluck!
Never accept NO for an answer. 
I have CBA Blue which is a subsidiary of BCBS of Vermont. I also have Connecticut Medicaid( Husky A).
My primary has a $250 deductible which I am putting the money into a flexible spending account every time I get paid. I also have 80% coinsurance and a $1500 out of pocket expense. Now it all of a sudden dawned on me that I may have to pay the $1500 up front! Yikes! I don't have $1500 to cough up right now and I sure as hell can't get a loan with my crappy credit!
Now since I have medicaid, will they pick up the out of pocket expense? Had I known earlier this year that I would be getting WLS, I would of been adding more $$ in my flexible spending account!!
I don't have a problem paying it if my surgeon doesn't expect it up front! I'm just scared now, it will take me a long time to come up with this money!
Our greatest weakness lies in giving up. The most certain way to succeed is always to try just one more time.
Oh that is GREAT! That is my Insurance too. I am hoping for brieng approved fast too.
Hockeymom87 · 0 replies · 858 views
