JLA1975

I have Antem BC/BS of California. I spoke with a sales liason who has helped me with many issues and he read my policy and informed me that it doesn't say yes and it doesn't say no as far as obesity treatment goes. It's kind of a gray area. He said that it will have to go through the managed care department for approval and it will have to be viewed as medical treatment for morbid obesity but not just obesity treatment. :smile2: I have the BMI (46) to qualify but at this time I don't seem to have any other comorbidities. I am living with chronic pain due to low back pain and a herniated disc much of which would be resolved if I lost weight. Not sure if that would count. Anyway just wondering if anyone had to jump through hoops with Anthem and had success??? Thanks!

I realize I probably posted this on the wrong board. Anway. I wanted to add two more questions. The Dr. I want to use is listed as a provider on my insurance but I don't see anything online about Obesity or Bariatric surgery. Are there more things covered than what is listed online under your plan?

I am getting the run around right now and I'm so frustrated. I contacted the surgeon who contacted the insurance who said I had bariatric coverage. Great! I schedule a consult and get a call a day before saying I'll need to pay out of pocket because morbid obesity is a plan exclusion. I explain to the woman that their office already checked and was told I have coverage. They called back and this time was told by the insurance that they can't confirm coverage that I have to go through the employer. OK fine. I call the people who manage our benefits and in the end the shuffle me back to someone at the insurance company who hasn't gotten back to me yet. He was working on it and then went on vacation. I have had to cancel 3 consultations waiting on this. I don't want to lay out the money for the consult because I don't think paying out of pocket is an option right now so a consult would be a waste of time and money. Any ideas?

Thanks for all the replies. This gives me a better idea of what kind of help I'll need. Luckily my mother in law lives near by and is very supportive so I know she'll help. We just got a mini van which my 3 year old and get in and out of herself ( I have back issues to begin with) so I don't have to lift her and my 4 month old isn't very heavy yet. I'll just have to not lug around that infant carrier. It also helps me hear that people with children have done this. Part of me feels guilty for even taking the risk of surgery when I have kids but I feel like I have to save myself to be a better mom.

I'm currently staying home with my 3 year old and 4 month old and I am starting the process for the lap band. I am just wondering what kind of recovery to expect and how long I would need help for, especially when it comes to things like lifting the baby. Thanks.

Thanks for your reply. It definitely gives a better idea of what to expect if my insurance doesn't have a pre-op diet requirement. I was thinking it would be months but it's good to know that maybe in a month I could have a surgery date.

Like what happens from consult to surgery? How long does it take to get a surgery date and what happens in between. I have Anthem so I'm not sure what there requirements are yet as far as pre-op dieting is concerned. Thanks so much!

I'm super nervous and excited at the same time. It's next Wednesday with Dr. Johnell in Greeley, CO. I guess that's probably normal to have mixed emotions. I have Anthem insurance and know I have bariatric coverage I just don't know how much of a hassle it's going to be. Hopefully not too much. Looking forward to being an active member of these boards.

Hi. I am just beginning this journey and if this is the path I take I want to be sure I choose the best physician. I am looking for recommendations for physicians in Colorado. Dr. Michael Snyder and Dr. Johnell have been mentioned to me so far. Thanks so much.