Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Why not insurance approval prior?



Recommended Posts

I guess I must be slow at catching on. Lol....I can't figure out why they do all the testing prior to getting surgery approval. You can go through all the tests and then not be approved. Then you have a bunch of medical bills you have to pay for nothing. Begining to wonder if it's a way for the doctor to make money whether you have surgery or not....Any ideas? Any one else wonder this?

Share this post


Link to post
Share on other sites

Well it was my insurance company that made me jump through hoops. The insurance company lets you know if you qualify with your BMI and/or health issues and then final qualifying if you follow their testing.

Share this post


Link to post
Share on other sites

My first choice doctor did the same. Had me schedule a visit with the cardiologists, shrink and labs. I called back to tell them I wanted to wait till I had insurance approval and what will insurance cover. I eventually dropped that doctor and glad I did. Didn't stop him from sending a $500 bill for one 10 minute consultation that my insurance did pay for.

I can see many patients go into some of these surgery mills and just get rolled over by all the medical jargon and starry eyed fantasies of being thin. And then the bills start rolling in.

Yup! Some doctors and their office just don't care and neither do the staff. On the other hand, it could stop a lot of morbidly obese people from having their surgery and achieving a healthier life. Don't know if it worse to bully people into spending the dollars or letting them go on with their sad unhealthy lifestyle? Heaven knows how many times I've heard myself and others on this forum look for excuses not to follow through with the plan?

tmf

Share this post


Link to post
Share on other sites

Insurance should pay if they require the test. They even payed for my tests, and I paid the surgery.

Share this post


Link to post
Share on other sites

Thanks for the info. My BMI is 40. I don't have any other health issues. I can just see me making a bunch of 80 miles round trips for all these tests and then my insurance denying me for some reason. How disappointing that would be.

Share this post


Link to post
Share on other sites

Thanks for the info. My BMI is 40. I don't have any other health issues. I can just see me making a bunch of 80 miles round trips for all these tests and then my insurance denying me for some reason. How disappointing that would be.

That's where you talk with the bariatric surgeons office and let them tell you if you qualify.

My ppl told me, no problem.

Best Wishes!

Share this post


Link to post
Share on other sites

In My experience, the insurance would not even take the paperwork for consideration of the surgery until all of the pre-op stuff was complete. Those tests, etc is what they base their decision off of. I went through 3 insurance companies before I got approved...let me tell you, it was an emotional process!

Share this post


Link to post
Share on other sites

In My experience, the insurance would not even take the paperwork for consideration of the surgery until all of the pre-op stuff was complete. Those tests, etc is what they base their decision off of. I went through 3 insurance companies before I got approved...let me tell you, it was an emotional process!

Share this post


Link to post
Share on other sites

In My experience, the insurance would not even take the paperwork for consideration of the surgery until all of the pre-op stuff was complete. Those tests, etc is what they base their decision off of. I went through 3 insurance companies before I got approved...let me tell you, it was an emotional process!

You make a good point. I think it would be helpful for the poster to research if her insurance will pay for bariatric surgery in the first place. Then move forward with the tests etc.

tmf

Share this post


Link to post
Share on other sites

You make a good point. I think it would be helpful for the poster to research if her insurance will pay for bariatric surgery in the first place. Then move forward with the tests etc.

tmf

That's what I did. I contacted my insurance company and they sent me the criteria for what my weight, health issues and testing I had to do. My Bariatric office also got that from my insurance company. So insurance Company approved my going forward and then all the paperwork was sent in for final approval and my insurance company paid for all the testing.

Share this post


Link to post
Share on other sites

Just an after thought

I was really happy that I had to go through all this testing because it gave me time to learn all I could about LBS and I believe it put me in a better position to succeed.

Thanks to everyone on LBT.Com I had the best on-line education!

Share this post


Link to post
Share on other sites

You make a good point. I think it would be helpful for the poster to research if her insurance will pay for bariatric surgery in the first place. Then move forward with the tests etc.

tmf

I contacted them. It is covered if your BMI of over 40 (which I am) or over 35 with comorbidities. I am just nervous that something is going to happen. Sorry, I'm just always "Nervous Nellie"....

Share this post


Link to post
Share on other sites

I contacted them. It is covered if your BMI of over 40 (which I am) or over 35 with comorbidities. I am just nervous that something is going to happen. Sorry, I'm just always "Nervous Nellie"....

You're ok, it's better to ask questions than going in blind.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Bashbee91

      Hey guys new to the process looking forward to this new life. 
      · 0 replies
      1. This update has no replies.
    • Bugg

      Hi everyone! I’m brand new here. I just went through all my pre-op requirements per my insurance company and now everything has been submitted and I’m just waiting for final approval and my surgery date. I’ve been doing research, watching YouTube videos, TikTok’s, ect.. trying to prepare my mind and what to expect so I’ll be ready for the surgery. I was so sure and so set and so ready and excited. However, now that I’ve done everything & it’s almost here, I am sooooooo scared! I know why I want it bc I’ve tried everything and I just don’t feel like I can lose weight by myself. I’m tired of being overweight my entire life. I’m miserable, but I keep psyching myself out afraid of GERD bc I know how that can be and I don’t want to have to get a bypass after already gaining the courage to even get VSG. I’m scared of complications like I’mgoing to regret doing it and be depressed that I didn’t just be more disciplined and try again to lose the weight on my own even sitting here typing this knowing in my mind i just can’t and don’t possess the discipline. I’m also afraid I won’t be able to handle the restrictions of the sleeve. What do I eat? I don’t know how to eat healthy really and don’t enjoy healthy food. I don’t know how to do this! I feel so defeated!Someone tell me they felt anything similar to this or am I not ready? I thought I was. I am so tired of being sick and tired and so tired of myself and so tired of being stuck and stuck in this body and somebody different on the outside from what I feel inside. I just want to ball up and cry.
      · 0 replies
      1. This update has no replies.
    • buildabetteranna

      over 20 lbs down since4 the pre surgery diet and surgery on the 14th
      · 1 reply
      1. Selina333

        Yay!! Congrats. I know how good that feels. 🤩

    • Jenopolis

      Had a sleeve in 2017, lost over 100 pounds. Had a DS surgery this year (2025) for more sustainable weight loss. 🤞
      · 0 replies
      1. This update has no replies.
    • buildabetteranna

      The 14th was my day. I am home and recovery is going pretty smooth. They even let me walk out of the hospital. Picture of me in recovery curtesy of my boyfriend lol. 

      · 3 replies
      1. DaisyChainOz

        Glad it went well!! Wishing you a speedy recovery and wonderful success!! 🤗

      2. buildabetteranna

        Thank you ❤️

      3. Selina333

        Neat you have a pic of this day! I was sooo happy to get my surgery. It was well worth it! And I'm not even near my goal. I had surgery Dec. 2!

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×