Pre Exisiting Condition Insurance ( Through The Govt) ? Does It Pay For Revision

[coltonwade 27]

Has anyone had any experience w/ the pre existing condition insurance through the govt paying for revision ( band to sleeve ) ?

I Have heard some rumblings of it ? Anyone have this insurance and had the revision ? If so what was the process ?

Thanks

[mrsnate 55]

I am not doing a revision since this is my first wls (hopefully only!) but pcip is covering my surgery. I was approved first try.

[coltonwade 27]

Really ?? I believe in the paper work i read it said WLS was excluded ? did it not say that in your paper work ?

do you mind PMing me Rebecca ?

Thanks

[kczar 166]

Rebecca, I'm glad to hear that you were approved. My paperwork was sent of last Friday. How long did it take for you to hear? I know that I spoke to my surgeon's insurance coordinator and she said she spoke with the person reviewing the request because they didn't think they had all the forms for the six month diet visits (they did have them.) I know someone else here was approved through PCIP so I'm pretty sure I'll get it. Just don't know how long they take to give the okay!

[coltonwade 27]

I am going to most likely going to apply next month . I am waiting.to see if I can get Medicaid . I am curious how long approval for a revision takes

[lovealways 22]

I am not doing a revision since this is my first wls (hopefully only!) but pcip is covering my surgery. I was approved first try.

What's pcip?

[coltonwade 27]

Pre existing condition insurance plan is pcip

[Mrs.E 3]

I am not doing a revision since this is my first wls (hopefully only!) but pcip is covering my surgery. I was approved first try.

I am just starting my attempt to get approved through PCIP. Can you give me any advice? They are not clear about what documentation they need for the 6 month diet and exercise. Any advice or guidance would be appreciated. I put a call into their Bariatric Surgery coordinator? I just need to know where to start and what they need. Thanks!

[kczar 166]

Mrs.E, are you going to use the nutritionist at your surgeon's office? If so, they should have a form that will be sufficient. If you're going through your PCP, they're going to need to give fairly detailed information for each visit. The ones mine used included:

My name

Date of visit

Current weight

Approximate times when I ate Breakfast, lunch and dinner

Examples of what I ate at each meal

Exercise - How often, how long, what kinds of exercise

Vitamins/supplements taken

Was I avoiding fats, fried foods and sugar?

Was I complying with the diet plan?

Doctor's signature and date

I switched from my surgeon's nutritionist to my PCP midway through the process and he just used the same forms. I called PCIP today and they have all the paperwork and I will hopefully have an answer by next week. I've seen several people on the board that have gotten approval first time around with PCIP, so I'm keeping my fingers crossed.

Good luck to you!

[Mrs.E 3]

Mrs.E, are you going to use the nutritionist at your surgeon's office? If so, they should have a form that will be sufficient. If you're going through your PCP, they're going to need to give fairly detailed information for each visit. The ones mine used included:

My name

Date of visit

Current weight

Approximate times when I ate Breakfast, lunch and dinner

Examples of what I ate at each meal

Exercise - How often, how long, what kinds of exercise

Vitamins/supplements taken

Was I avoiding fats, fried foods and sugar?

Was I complying with the diet plan?

Doctor's signature and date

I switched from my surgeon's nutritionist to my PCP midway through the process and he just used the same forms. I called PCIP today and they have all the paperwork and I will hopefully have an answer by next week. I've seen several people on the board that have gotten approval first time around with PCIP, so I'm keeping my fingers crossed.

Good luck to you!

I am unsure who to use. I just started by going to my PA. I initially saw a different surgeon, but the hospital was not yet certified as a " Center Of Excellence" so I am regrouping and trying a different surgeon. I will make sure my PA documents my progress the same as the example you gave me until I can see about seeing the nutritionist at the surgeons office. Thanks so much!

[blessedbeauty85 6]

Mrs.E' date=' are you going to use the nutritionist at your surgeon's office? If so, they should have a form that will be sufficient. If you're going through your PCP, they're going to need to give fairly detailed information for each visit. The ones mine used included:

My name

Date of visit

Current weight

Approximate times when I ate Breakfast, lunch and dinner

Examples of what I ate at each meal

Exercise - How often, how long, what kinds of exercise

Vitamins/supplements taken

Was I avoiding fats, fried foods and sugar?

Was I complying with the diet plan?

Doctor's signature and date

I switched from my surgeon's nutritionist to my PCP midway through the process and he just used the same forms. I called PCIP today and they have all the paperwork and I will hopefully have an answer by next week. I've seen several people on the board that have gotten approval first time around with PCIP, so I'm keeping my fingers crossed.

Good luck to you![/quote']

Before applying for PCIP insurance, I had already started doing the supervised doctor visits. I don't know if they will be as detailed as this, but I know we discussed my weight and what my problem foods are (if I hadn't lost any weight). So my questions are:

* if my doctor's forms aren't as detailed as this, will that delay my approval?

*is 6 months of visits with a nutritionist required as well as 6 months of visits with your PCP?

Thanks in advance!

[kczar 166]

You don't have to go to both a NUT and your PCP. PCIP will accept either to count for your supervised diet. I switched over because my surgeon's NUT left on maternity leave. Plus my insurance didn't cover the cost for the NUT but did cover my doc.

Regarding the details, my surgeon's insurance coordinator said they want that kind of info. She said a summary letter wouldn't cut it. Do you need all of the info? I can't say for sure. But I know they use this form all the time so I trust that it gets the job done.

[blessedbeauty85 6]

Thanks do much kczar! You're so helpful because not many people know about PCIP insurance so I really don't have anyone to ask. Did you do your whole 6 month supervised weight loss with after you got approved? Or had you already started the process?

[kczar 166]

bb85, you're welcome. This insurance has been a Godsend to me as I've been without insurance for 10 years.

Here's how I did the process. I initially got the insurance because I needed to get my gallbladder removed and surprise, surprise, no insurance company would cover me. I started with PCIP on 1/1/12 and had my first physical in a decade that month. My PCP (whom I've used for years) mentioned the sleeve as a possibility for me (he had been sleeved the year before.) I then contacted PCIP to find out if there was a surgeon in my area that was in network. Went to an information session and then started seeing his NUT. Halfway through I realized I could use my PCP. I asked if he would fill out one of the forms using the date of my physical back in January and he agreed. So I was able to finish up a month before I originally thought.

My surgeon's insurance coordinator wouldn't fax in any paperwork for approval until I had completed those six months. He also required an endoscopy and a psych eval (neither are required by PCIP), which I did earlier. They faxed in my paperwork on the 29th and it's being reviewed now. I called Monday and they said to call back in a week as they should have an answer by then. I've seen about three other people on this board that went through PCIP and they got approved the first time around. *Fingers crossed* it's the same with me.

But yes, get all your requirements done, make sure you selected a surgeon that's in network and operates out of a center for excellence and you should be golden. I haven't had them turn down anything yet, including surgery to correct my deviated septum.