EmilyIsSleeved

Well, my insurance process didn't go good at all. I submitted all of my stuff in March just to get a call saying that bariatric surgery was not covered in my plan as of January 1st. The insurance company made these changes without even bothering to tell me about them. I sent in an unsuccessful appeal saying it was wrong for them to deny me since they changed the details of the policy without telling me. I find it very suspicious that they changed the policy shortly after I started making calls asking about coverage for the sleeve... I got so sick of dealing with them, so when the new year rolls around, I will be switching insurance companies. If I am denied by the next company, I will just do self pay. Anyway, I hope my story didn't scare you because I know of alot of people who are now getting approved through bcbs of mn. However, make sure you dont end up like me. If I were you, I would call every other week or two just to check on your policy, because believe me, the only notification you will get about a policy change is when you get your first denial letter. Good luck and let me know how things turn out for you!

I have been going through the process of getting insurance approval through BCBS of MN. I just finished my six month supervised diet, psych eval, etc. just to get a denial call today. The reason for the denial was exclusion of bariatric surgery services. The insurance company told my surgeon's office that starting January 1st of this year that they changed the policy to exclude bariatric surgeries. I wasn't even aware that the policy was changed until my surgeon's office called me today saying insurance wasn't going to cover any bariatric procedure. My question is that since I started meeting with my surgeon and my dietician prior to this change (I started seeing them in October 2010), is there a chance that I can file an appeal and win? If anyone has had a successful appeal of a denial based on exclusion of services, I would love to know how you went about your appeal. Thanks for all the help!

I had this same question for my dietician when I first started my supervised diet. I thought the first visit wouldn't really count as being part of the six months since I wasn't technically on a diet yet. However, my dietician told me that you only need 6 visits total. Since I was extremely paranoid that maybe my dietician was wrong and that I really needed 7 visits, I called my insurance coordinator, and she also said you only need 6 visits. Hope this helps!

I would definitely appeal it. My information is being submitted tomorrow to BCBS of MN (about time, seems like I have been waiting forever) and I know they will deny on the first time around because like you, I don't really have any other problems except for being morbidly obese. However, I talked to the insurance lady at my surgeon's office and she said that even if they deny me the first time around, I need to keep appealing because she thinks by this summer BCBS of MN will change their policy just based on how quickly other policies are changing. She said that other BCBS policies nationwide are changing, so it is only a matter of time before MN changes theirs. You won't lose anything by trying to fight back through an appeal. It is worth a shot. Good Luck!

I was going to send in the papers last week, but my dietician decided I should probably have one more meeting with her on April 1st just to make sure I completely meet the standards of the six month diet. So unfortunately, I need to wait and submit my stuff on the Monday following my last dietician meeting. I am hoping to have the surgery done at some point this summer (preferably June or July), but I guess it is all up to the insurance company. I am planning on having my surgery done at the Sanford hospital in Sioux Falls, SD (it was the closest hospital to my house that offers bariatric surgery). I am very concerned about not getting approved as well. It would make me so mad and disappointed to go through all of the evaluations, diet consultations, and doctors appointments just to find out they won't approve me. I guess only time will tell. Keep me posted on how your insurance coverage turns out. Good luck!

I am also 18. I was also interested in getting the lap band since it could be taken out if there was ever a problem, but after talking to my doctor about it, I changed my mind and decided I wanted a sleeve. Currently, I have a BMI of 47 and both of my parents have had WLS in the past. I know getting WLS at 18 might seem drastic to some, but I would much rather get it done now instead of remaining obese for many more years. Getting the surgery now also helps prevent me from getting co-morbidities such as heart problems, sleep apnea, etc. Obviously since I am also your age and looking into surgery, I say go for it. It's your body and if you think surgery is the best option, then don't worry about what other people think because years down the road when you are fit and healthy, you will be so happy that you got the surgery at a young age. Good luck!!

You are probably getting tired of emailing so many people lol. If you are not too sick of emailing it, I would also be interested in a copy..my email is mombasa22@yahoo.com Thank you so much!

I will be submitting my information for insurance approval through BCBS Minnesota in a couple weeks. The insurance lady at my doctor's office told me that people requesting the sleeve are usually denied the first time around due to the surgery being considered "investigational/experimental", but that most people are accepted after making an appeal. I will let you know how my insurance coverage turns out as soon as I know. Hopefully we can both be covered, even though it seems like Minnesota just wants to make things difficult for us.

Hello everyone, My name is Emily and I am 17 years old. I know that some people may think that teenagers getting banded is a bad idea, but I am still very interested in learning more about this surgery anyway. I guess my question is, if you are a teen that got banded, or are going to be banded soon, what kind of process did you have to go through? Like was there more difficulty to be approved by insurance? Oh and by the way, my BMI is 47. I am 5 ft 1 inch (short I know haha) and I weigh about 250 pounds. So the only main requirment that I dont fit is the age. However, I will be 18 in about 6 months. Thanks for all of your help. Also, if anyone is willing to email me or something to talk, that would be great!

Thanks for all of the support everyone :wub: I know that getting banded will be a big change, but I think it is a good choice for me because I want to prevent becoming like my parents health wise. Both of my parents were about 350-400 pounds each at their heaviest, they both had high blood pressure, and they both ended up getting WLS. However, their surgeries re-routed everything and personally, I don't want to change my insides that drastically to become healthy. Thanks again to everyone who posted!!