Sarah 82
Pre Op-
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About Sarah 82
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J Germaine Johnson reacted to a post in a topic: I work with Insurance.
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Steph~L~16 reacted to a post in a topic: Gastric sleeve/menstrual cycle
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LadyKate reacted to a post in a topic: I work with Insurance.
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madface reacted to a post in a topic: PCOS hair and period issues
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Sarah 82 reacted to a post in a topic: Anyone from North East Texas?
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Sarah 82 reacted to a post in a topic: PCOS hair and period issues
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SusanB55: not all insurance plans require a supervised diet and/or weight loss prior to surgery. I also have BCBS and my plan didn't require it. The preop diet is usually recommended more as a way to get you prepared for how you'll eat after surgery. Some surgeons also do it so you can shrink your liver to make it easier during the procedure. Sent from my iPhone using the BariatricPal App
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Sarah 82 started following Confused about insurance requirements for bariatric surgery, PCOS hair and period issues, PCOS hair and period issues and and 4 others
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I have PCOS and I'm currently 5 months post op sleeve. I just recently started having issues with my hair falling out. However, the hair everywhere else has started growing in like crazy on my face, neck, and even my lower back! I've always had problems with the hair in those areas but it's been controllable. Now no matter what I do or how often it seems it just keeps coming in thicker and thicker. Anyone else experience this? Also, how long after your sleeve before you started ovulating? Sent from my iPhone using the BariatricPal App
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I have PCOS and I'm currently 5 months post op sleeve. I just recently started having issues with my hair falling out. However, the hair everywhere else has started growing in like crazy on my face, neck, and even my lower back! I've always had problems with the hair in those areas but it's been controllable. Now no matter what I do or how often it seems it just keeps coming in thicker and thicker. Anyone else experience this? Also, how long after your sleeve before you started ovulating? Sent from my iPhone using the BariatricPal App
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I'm from Henderson, TX and was sleeved November 2015. Sent from my iPhone using the BariatricPal App
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Henderson! Anyone else in the North East Texas area? Sent from my iPhone using the BariatricPal App Henderson! Anyone else in the North East Texas area? Sent from my iPhone using the BariatricPal App
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Gastric sleeve/menstrual cycle
Sarah 82 replied to LMSWNYC's topic in Pregnancy with Weight Loss Surgery
I also have PCOS and I'm now 5 months out from the Sleeve. I went from September till February without a period, which isn't totally abnormal for me. Then it came like normal in March. Nothing so far this month. My doctor recently reduced my Metformin dose since my blood sugar is better than before surgery. My endocrinologist just advised me to be patient because my body is still adjusting to everything. Sent from my iPhone using the BariatricPal App -
If your Medicaid will pay for it, that's going to be your best option because you won't have any cost share. Also, idk what state you're in but for Texas, it's very rare that you would qualify for Medicaid if you've got commercial insurance. That said, yes, there are several insurances that have bariatric coverage. Sent from my iPhone using the BariatricPal App
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I worked with True Results out of Dallas also and had surgery at Baylor. I also work with insurance and telling patients how much they'll owe for procedures as part of my job. I ended up having to be the one to explain to Baylor what my bariatric benefits are. They had them all messed up. I can tell you that $8000 is the most you'll pay out of pocket for ALL medical services until your plan rolls over. If you want, I can look into it for you from a provider's viewpoint. If you'll send me an email with your full name, DOB, and insurance info I'll see what they tell me about it. I have access to a few more resources than you probably do. My work email is Sarah.seelbach@uthct.edu Sent from my iPhone using the BariatricPal App
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Andi07 reacted to a post in a topic: I work with Insurance.
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Confused about insurance requirements for bariatric surgery
Sarah 82 replied to rocal6356's topic in Insurance & Financing
The patient advocate with true results is probably not the person that's actually in charge of getting your prior authorization approved. I used True Results in Dallas and my advocate told me I was good to go but it was a different person that called to verify my requirements etc. My suggestion is to call your insurance again and ask for specific benefits for your plan. I work with insurance as part of my job so if you'd like me to check into it for you I can one day this week from work. Just send me an email with your full name, DOB, and id#. sseelbach@live.com Sent from my iPhone using the BariatricPal App -
It sounds like it's just in medical review right now. That's not necessarily a bad thing. Also, policies vary so just because someone else with Cigna got theirs approved that soon doesn't mean yours would've been. Some insurances even have what's called a predetermine period and those can take up to 30 business days. If you'll send me an email with your full name, DOB, ID#, and the exact name of the insurance on your card I can look into it further this week at work. There may be something they're waiting on in order to process a decision. Sseelbach@live.com
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Sorry I didn't get a notification with your post. If you still need help, send your name, dob, and insurance id to my email. I'll check your benefits from work this week. Sseelbach@live.com
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You'll be considered a self pay patient. The only option you have is to find out how much the facility where the surgery will be will cost. They're who you'll have to pay upfront. Most facilities will give self pay patients a 50% discount off the total cost of the surgery. Then you'll probably be expected to pay half of that upfront. Where I had mine done, it would've been about $15k if I wouldn't have had insurance. That doesn't include any inpatient stay.
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Sarah, If my employer excluded all Bariatric procedures in our coverage, what options do I have?