Recent Posts

Sarahlicious
on 8/1/13 2:12 pm - Miami Shores, FL
Topic: RE: abdomioplasty quedtion

Yes, have doctor document the skin issues, and Tricare is known to cover at least a panniculectomy, removal of the skin, they might not cover a full abdominoplasty with muscle tightening, but you have enough need to go for a consult and get the PS opinion on what he can do and what documentation he can submit for coverage.

I have Lipedema and Lymphedema. I also have a passion for Obesity and Health Insurance Advocacy

Blog: born2lbfat.com Facebook: Born2lbFat Twitter: @born2lbfat

Sarahlicious
on 8/1/13 2:09 pm - Miami Shores, FL
Topic: RE: getting health insurance 11 years after WLS

I've only heard of people having to wait 5 years to be covered. Even if they tried to say WLS is a pre-existing it should not go back 11 years!

I have Lipedema and Lymphedema. I also have a passion for Obesity and Health Insurance Advocacy

Blog: born2lbfat.com Facebook: Born2lbFat Twitter: @born2lbfat

Sarahlicious
on 8/1/13 2:07 pm - Miami Shores, FL
Topic: RE: m

That looks pretty thorough, weight/height, and discussion of diet plan!

I have Lipedema and Lymphedema. I also have a passion for Obesity and Health Insurance Advocacy

Blog: born2lbfat.com Facebook: Born2lbFat Twitter: @born2lbfat

Sarahlicious
on 8/1/13 1:23 pm - Miami Shores, FL
Topic: Advocate: 10 Years in the Making

My story of WLS, Lymphedema and Lipedema is currently on the home page and here!  You won't want to miss it!

 

sarah

I have Lipedema and Lymphedema. I also have a passion for Obesity and Health Insurance Advocacy

Blog: born2lbfat.com Facebook: Born2lbFat Twitter: @born2lbfat

kitkat88
on 7/31/13 10:14 am, edited 9/7/13 11:29 pm - Metairie, LA
RNY on 11/18/13
paula K.
on 7/28/13 7:19 am - newnan, GA
DS on 12/04/13
Topic: RE: FEPBLUE APPROVAL FOR DS?

I just found your post as I am also looking at a DS with FEPBLUE (Standard).  Did you ever get any information?

CPA_Loser
on 7/27/13 12:32 am, edited 7/27/13 7:29 am - WA
Topic: RE: Aetna ughhhhh HELP!!!
I have Aetna as well and they directed me to the clinical bulletin. You need to read what the specific criteria is for the two different options. Your surgeons office should be able to help you as well since I am sure they have had other patients in the past that have had to meet Aetna's criteria. Hope you figure it out!
Mary O.
on 7/24/13 5:35 am - Dallas, TX
Topic: getting health insurance 11 years after WLS

My husband's job was eliminated-COBRA ends in August. We're being told that I cannot get coverage through any of the major insurance companies because I've had WLS.  I had Roue-en-Y in Oct of 2001--no complications-have just kept of 130 lbs for 11 years. Had a full physical this month.  No prescription meds-no health problems other than borderline high cholesterol and I was told to take OTC krill oil to bring it down, not RX statins.

 

Would I have the surgery again? Yes-just wish I had known this would be one of the results. If you don't disclose the surgery and they find out they drop you anyway.

 

Now I go into temporary insurance until January and pray that Obamacare kicks in.

nebrasfield
on 7/23/13 9:56 am - North Little Rock, AR
Topic: abdomioplasty quedtion
I lost over 100 lbs going from 300 lbs to my lowest of 168 lbs. Then I got pregnant, 8 mos after my gastric bypass. Then 8 mos after that child I had another. Yes, I'm finished having babies, but now I have a good amount of skin in my abdomen area and toward back. Hanging skin. I'm am working out considerably so I'm sweating a lot. Basically my skin folds are irritated, itchy and a rash that I'm managing. Does anyone have any experience getting doctor to agree with this being a health risk, medical necessity, and thus having insurance cover it. I have Tricare insurance. I'm do have some ailments that I did have before surgery, went away after surgery and now is back with the many weight gain. Its high blood pressure. I take meds to control it.

Nicki
        
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Jen1014
on 7/23/13 8:55 am
Topic: Aetna ughhhhh HELP!!!
Hi all I am so frustrated with the pre-certification department for Aetna through my companies insurance. I am a nurse,so I get the needing everything in order quite honestly! I have done all my question asking to the benefit dept etc and have been advised from them to get my bypass done this year d/t all out of pocket and deductibles being met already ,so I have been going like mad fire to get everything in order. Surgeon,sleep study, letters of recommendation from all my current Dr.'s etc! You name it I got it and if I don't I can get it in 24 hours or less, this is exciting of course. You say then what's the problem? Well the surgeon asks about this medically supervised diet and I'm like a what so I call Aetna to confirm and they can't decide out of 4 calls what the rule is in regards to this criteria?? I ask for a copy of these criteria's and well you know it's against company policy so she then states I can go on Aetna's website and pull up the clinical bulletin and it's all there and basically says you can do the 6 month supervised or the 3 month Multi disciplinary surgical preparatory regimen. My questions after this long winded story are #1 has anyone been through this with Aetna and #2 is the surgeon/nutritionist/psychiatrist combo enough for the 3 months??? Thanks all for reading my long winded story.
Jen
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