Recent Posts

Father Don
on 11/10/10 5:25 am - Charleston, SC
Topic: RE: New member, frustrated...need advice
Hurray for you!

See, there's ALWAYS a way around - sometimes you just have to look for it or work at it....

Soon you'll be a loser like the rest of us!  Congrats!

Obesity Help Support Group Leader
 

giwhiz93
on 11/10/10 5:22 am - Sheffield Lake, OH
daisy1975
on 11/10/10 5:14 am - North Canton, OH
Topic: RE: Summacare
I have Summacare insurance and I only had a 3 month weight check plus I think they look at previous weight checks if you have a primary care doctor records.  I would call the office and talk to Bev the financial counselor.  Hope this helped.  Goodluck.

Noel
stacyinohio
on 11/10/10 12:20 am
stacyinohio
on 11/10/10 12:19 am
Topic: RE: New member, frustrated...need advice
Exactly...while UHC is a network provider for lots of bariatric centers locally, anything related to the treatment of obesity (including morbid obesity) is not covered..under my particular plan.  They said it on the phone, I saw it on the website, I read it in my plan documents.  It's an exclusion on my policy?  Sounds crappy.  It is.  But is it the truth?  You betcha.

BUT.  Good news.  No, GREAT news.  While we are in the midst of open enrollment here at my job, my husband's employer is also in their open enrollment period.  And after doing some research yesterday, his insurance now seems like the more attractive option.  He is a federal civilian employee and I was thrilled to learn they completely cover the surgery, with the exception of a $100 surgery fee!!
Krissymk
on 11/9/10 11:49 pm
Topic: Summacare
 Hello-

I have Aetna at my current employer and have a job interview Friday for a company that uses Summacare insurance. I am going through the process of getting RNY and should be getting surgery in Feb after I finish my 3 month required diet.

Aetna requires a 2 year weight history....does anyone one know how long of a weight history Summa needs? 

Thanks!!!
sfmini
on 11/9/10 11:56 am
Topic: RE: New member, frustrated...need advice
The WLS exclusion has to be from your company, not UHC as they covered my sleeve with no problem.
    
rebeccja
on 11/9/10 10:40 am
Topic: RE: I got A Date!!
Congrats and enjoy the journey. I have had a great journey. I was dishearted at first and now go to the gym 3 to 4 times a week for 2 to 3 hours. You will love your new life if you embrace all you can achieve. God bless you
    
Father Don
on 11/9/10 5:28 am - Charleston, SC
Topic: RE: New member, frustrated...need advice
Is it becaus eof your company?  Have you asked for documentation for YOUR policy, including all riders/exclusions?

Sounds sketchy that NOTHING is covered.  Don't go by one person you talked to on the phone.  Make sure it's the policy that explicitly covers you - with all riders and exclusions.

Some employers add exclusions or do not pick up WLS riders so reduce costs.  You can ask your HR department to help you get the info you need. 

Another option is to look at becoming self-insured for a year - and make sure it includes those options.

If you have a spouse, investigate their insurance.  While you may have to wait to get on that policy, it might be worth it.

Saving money via Flexible spending accounts is another way to pay (pre-tax) for the procedures....

Look at going to Mexico as an option.

Also, Cleveland clinic is constantly doing studies about conditions that can be corrected via WLS - contact them and see if you qualify for any.  STAMPEDE is one - it's to show how WLS "cures" diabetes and researching why....


Obesity Help Support Group Leader
 

stacyinohio
on 11/8/10 10:13 pm
Topic: New member, frustrated...need advice
I have been doing lots of homework on weight loss surgery and I'm in the process of exploring my options.  Though I have United Health Care, I was REALLY disappointed and saddened to learn this morning that my plan does not cover anything weight loss related, procedures or anything, even including those related to morbid obesity.

So now what? 

:(

There is no way for me to pay out of pocket for this surgery......
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