INSURANCE! if u dont mind responding

[jasleeve 440]

i wanted to start a thread about insurance. it would be greatly appreciated to all pre-op patients if we all had an idea of what insurance you have and if they denied you or approved you. also, what were the requirements made by your insurance company because some are different.

i have 1199SEIU affiliated with aetna. ive read stories about aetna approving so im assuming mine would too but i wont know until i talk to my surgeon. i called my insurance company & the lady gave me the run around & couldnt say, "YES, WE COVER VSG!" or "NO, WE DONT COVER VSG!" so its a dreadful waiting game.

thank you to all the people who respond. us pre-op'ers definitely appreciate it. <3

[Khy 16]

My Aetna (DOD) covers vsg. It remains to be seen if they will cover me... Aetna is known to be very picky.

Khy

[TonyaG 0]

Aetna covered me and has been awsome. My person who pre approved it had gastric bypass herself. She has done follow up calls to make sure all is well. Had to do the three month physician diet, physc. evaluation and thats about it.

very pleased with them!

[jasleeve 440]

My Aetna (DOD) covers vsg. It remains to be seen if they will cover me... Aetna is known to be very picky.

Khy

thats great to know! what were your requirements and have you been sleeved already?

[jasleeve 440]

Aetna covered me and has been awsome. My person who pre approved it had gastric bypass herself. She has done follow up calls to make sure all is well. Had to do the three month physician diet, physc. evaluation and thats about it.

very pleased with them!

wow! thats great. i pray i get the same results as you!

[SmokyMtnGal2011 10]

I am so grateful i have CIGNA. they cover lots of WLS and VSG is one of the procedures. Requirements are 6 mos supervised diet, pschy eval, nutritional eval, BMI > 35 with co morbidities, past history of weight loss attempts (my PCP provided excellent info on this), blood work then hurry up and wait. Once all is submitted, it will take about 1 week for the approval letter and then I can schedule the surgery(approval letter is good for 6 months). I was told by my surgeon staff that CIGNA is one of the better Insurance companies they deal will. I hope this is the information you were looking for.

[jasleeve 440]

thank you for responding & thats great! i have been over weight my entire life so i plan on gathering history for the last 5yrs. ive been on weight loss meds thru doctors & will be getting my personal trainer to vouch for me. hopefully, all this will help! my bmi is 49.1 which is extremely high. im only 5'1 & 22 yrs old. :-/

I am so grateful i have CIGNA. they cover lots of WLS and VSG is one of the procedures. Requirements are 6 mos supervised diet, pschy eval, nutritional eval, BMI > 35 with co morbidities, past history of weight loss attempts (my PCP provided excellent info on this), blood work then hurry up and wait. Once all is submitted, it will take about 1 week for the approval letter and then I can schedule the surgery(approval letter is good for 6 months). I was told by my surgeon staff that CIGNA is one of the better Insurance companies they deal will. I hope this is the information you were looking for.

[SmokyMtnGal2011 10]

JASLEEVE

I am so glad that you decide to do this while you are so young. You probably will not have the "hanging skin" that us old folks will have to have something done to get it gone. I wish when I was younger this opportunity was available. Please keep us posted on your adventure and don't give up!!!! YOU ARE WORTH THE EFFORT!!!!!

[jasleeve 440]

thank you very much!!! i hear my insurance pays for plastic surgery to fix the hanging skin. i wouldnt mind a nice tummy tuck! lol. >_<

i will definitely keep you and everyone updated! i appreciate the kind words. youre awesome.

JASLEEVE

I am so glad that you decide to do this while you are so young. You probably will not have the "hanging skin" that us old folks will have to have something done to get it gone. I wish when I was younger this opportunity was available. Please keep us posted on your adventure and don't give up!!!! YOU ARE WORTH THE EFFORT!!!!!

[Margaret 4]

Mine was exactly the same with CIGNA and my surgery group. And I'm in the Smoky Mtn area as well. It took me about 7 months from start to finish with the requirements and waiting. All experiences were very timely and done in an efficient manner.

I am so grateful i have CIGNA. they cover lots of WLS and VSG is one of the procedures. Requirements are 6 mos supervised diet, pschy eval, nutritional eval, BMI > 35 with co morbidities, past history of weight loss attempts (my PCP provided excellent info on this), blood work then hurry up and wait. Once all is submitted, it will take about 1 week for the approval letter and then I can schedule the surgery(approval letter is good for 6 months). I was told by my surgeon staff that CIGNA is one of the better Insurance companies they deal will. I hope this is the information you were looking for.

[jasleeve 440]

Mine was exactly the same with CIGNA and my surgery group. And I'm in the Smoky Mtn area as well. It took me about 7 months from start to finish with the requirements and waiting. All experiences were very timely and done in an efficient manner.

thats great! ive heard shorter times. im so anxious that i wish i was going in tomorrow lol

[SmokyMtnGal2011 10]

Margaret I am glad there is another East Tennessean among us. I am having my surgery through the New Life Bariatic Surgery Center in Knoxville - where are or did you have yours?

[FindingReneeAgain 2]

I have United HealthCare and they covered my procedure. I called and spoke with them and they told me that it could be covered if I met the criteria. They needed a five year weight history, past attempts at losing weight and medical conditions, and a BMI greater than 40. Testing for me included Upper GI, Endoscopy, Psych eval, following a diet with my nutritionist and showing commitment to change, EKG, bloodwork etc.. I started the process at the very end of March, took my appointments 3 to 4 a day when possible, and had my surgery June 22nd. Good luck to you!

[KristeyK 3]

Your individual insurance policy, no matter which company you have, is what determines whether or not they cover the surgery. For instance, I have a friend who also has United Health Care, but her company didn't have the bariatric rider in their policy, so it's not covered for her.

I have United Health Care for Railroad employees and just got word today that I was approved! (Not just ANY approval, but a band to sleeve revision, which is NOT common for carriers to cover.) For any WLS, they require a BMI of 35 and co-morbidities, or a BMI of 40+.

[Billie Jo Brown Alexander 5]

Your individual insurance policy, no matter which company you have, is what determines whether or not they cover the surgery. For instance, I have a friend who also has United Health Care, but her company didn't have the bariatric rider in their policy, so it's not covered for her.

I have United Health Care for Railroad employees and just got word today that I was approved! (Not just ANY approval, but a band to sleeve revision, which is NOT common for carriers to cover.) For any WLS, they require a BMI of 35 and co-morbidities, or a BMI of 40+.

I have united through the railroad as well. How hard was it to get approval and how long did it take? I'm so nervous and anxious about ins approval. Was there any special stipulations such as 6mos of dieting/