prowinewoman

I am starting a new job on Monday and have to make a decision by then about which health insurance to pick, and I have narrowed it down to Kaiser or Anthem BC. I am hoping to have gastric sleeve surgery this summer. The Kaiser plan (after my employer contribution) will cost me $90/month but has a $6,500 out-of-pocket maximum, whereas the Anthem will cost me $190/month but only has a $3,000 out-of-pocket maximum. It looks like their coverage and requirements for the surgery are about the same but sometimes it's hard to know until the process is started. I can always choose a less expensive plan next year during the open enrollment after my surgery has (hopefully!) been completed. Wondering if anyone can share their experiences with me if you have either of these insurances. The thought of a "one-stop-shop" for Kaiser sounds appealing, but not sure if it's worth the extra out-of-pocket expense. Thanks in advance!

Thanks for your feedback everyone (and congrats to you all on your success!) I've had Anthem BC for the last 7 years and have been overall happy with it, but LivingFree you have some good points about setting you up for long-term success. (I live in the Bay Area, and the Kaiser Richmond facility would be the closest to me). But, the idea of not having to deal with a waiting period or dr-supervised diet is very enticing! I've been thinking about this surgery for years (joined this site in 2009), and have tried many other non-surgery evenues in the meantime and I have decided that this is the route I am meant to take. It would be nice to jump in and get started right away. Tough decision, I have a lot to consider by Monday!

I'm just trying to get a feel for how long the process is. I know it is different for everyone depending on insurance and other circumstances, but I would like to hear from as many of you as possible to see the quickest, longest and average times! Thanks everyone!

Thanks everyone! I knew there would be a pretty wide range (never thought about how much quicker self-pay would be!) but this gives me a good idea of different timelines.

I see that a "psychiatric evaluation" of some sort is required by many insurance companies prior to approval. Can anyone explain to me what this entails? I am currently on anitdepressants for mild depression (going through a nasty divorce), and am wondering if this hurts my chances of getting approved... Or are they just asking questions to make sure you have realistic expectations of the procedure and outcome? Thanks.

Thanks for your input everyone! That makes me feel a lot better about this! I've taken tests like that before for jobs, and while I think they are a little silly (is anyone going to actually answer that they hurt small animals?!) I guess there is some validity to them. Phranp - that's a great idea to find a therapist that specializes in obesity medicine. I saw a therapist a few times after I left my husband, but she is more of a family counselor. Finding someone who is more in-tune with the emotions of WLS might be something worth checking into. Not sure what the protocol will be yet for the testing - I have my first appointment with my Internist next week to get the ball rolling!

I am in the VERY beginning phase of researching the lap-band procedure, and these 2 hospitals are covered by my insurance (Anthem/BC of CA). Has anyone in the Bay Area researched these 2 facilities? And if so, which one did you wind up choosing and why? I live in the Napa Valley, so SF and Davis are almost equal distance, but I have to say that Davis is a much easier drive to get to! Thanks for any help!