Not yet banded...i'm too confused.

[Agent_weinbach 9]

Okay, I've never had insurance and now I have some starting in January. I'm not too certain how I start this process. Do I first get in contact with my insurance to make sure they even cover it, contact the bariatric center or a clinic first? I'm not sure what step to even take first.

[btrieger 21]

I'd call the insurance company and ask.

The bariatric center could probably tell you as well. You can let them do the leg work.

[Agent_weinbach 9]

Okay that is what I will be doing! Thanks! At work, in our policy coverage, it does state it covers wls and some of the criteria is listed. I'm sure there is more to it than that though since that is just an overview.

I wasn't sure if I should wait to reach out to an actual center that I will be getting my band until I know if I need the whole 6 mo diet or anything like that. So insurance and center, then if the medical diet is needed, the doctors...correct?!?

[Yvette1026 0]

Make the 5-10 minute call to your insurance.

Ask them the following:

1.) Do they cover the surgery?

2.) What requirements are there for them to cover the surgery? (BMI, Co-morbidities, etc...)

3.) What is required of you to obtain the surgery (6 month diet plan?, year of proof of weightloss, etc.. - every insurance has different requirements)

4.) Do they have a preferred WLS surgeon or provider in your area?

[Yvette1026 0]

Once you know what's required, if they didn't refer you to one, make an appointment to go to a seminar. Research surgeons in your area and go check them out.

I say avoid going before you know, because some places will pressure you to go self-pay and/or have you pay for "testing" that your insurance would normally cover.

[Agent_weinbach 9]

Sound great! Thank you so much!

[Agent_weinbach 9]

Another question, should I start this Jan 1st or should I be calling now? I don't know if anyone would be willing to help yet.

[Yvette1026 0]

Depends on your insurance. Some insurances let you get to a live person without entering your information and some require you to be active in the system before they'll speak to you. BCBS and aetna for example require you to be a member before they provide you information, unless you're calling their sales line.

[Agent_weinbach 9]

I'm so dumb when it comes to insurance. Thank you for all of your help, really.

[Yvette1026 0]

No worries, I used to do benefits administration for a living, even though it seems like a lifetime ago, the knowledge is still locked in there lol