I think my surgeon must have checked with my insurance company prior to having done all the prerequisites for approval and they told them it was a covered procedure.
I had to go on a 6 month medically supervised diet, see a nutritionist, and have a psych eval(its easy). Through that whole time I worried about getting approved. I had a BMI of 38 with no diabetes, high cholesterol,etc. The only thing I can think of that I had was bad knees( due to the weight).
After I finished my prerequisites and had all my info sent in
I was a nervous wreck. After a couple of weeks the bariatric program called and told me I had been denied because it wasn't a covered procedure which they did not understand because they had been told that it was covered.
The bariatric program told me not to give up and they told me some things I could try to get approval. I was DEVASTATED for 3 days. They called me back on the 3rd day and told me the insurance company had called back and said it was a covered procedure. So I went from having a covered procedure to a not covered procedure back to a covered procedure. The story gets even stranger: A lady I work with has a BMI of >40 and has the comorbities(diabetes, cholesterol etc) has gone to 2 separate bariatric programs(1 was the one I used) and they have told her its not a covered procedure under her insurance. We have the same insurance company
(through work). The only difference we can figure out is that I bought the more expensive plan and she didn't. We don't know if that would really make the difference or not
or its some arbitrary thing the insurance company came up with.
Good luck to you and I hope you get your band.