Waiting On Health Alliance Illinois *** Approval

[Pam2011 26]

I found out on Monday I was team approved at my Bariatric program to have surgery so I picked my surgery date as June 11, 2012. They sent all my paperwork into my insurance co on Fri, 4/13/12. I talked to the bariatric program yesterday and she said Health Alliance usually decides within 1-1 1/2 weeks. I am hoping to hear something by April 27. I hope they approve me cause I am unable to pay for this surgery unless my insurance covers most of it less my deductable and some other fees.

Anyone have any experience with this insurance co?

Thanks in advance!

[Condessa 3]

A few years ago when I first started looking in Bariatric surgery I had Health Alliance and you had to complete the "new you" program, is that still one of their requirements? I switched last year to Health Link because the sleeve was not covered by Health Alliance. Aside from some out of pocket expenses ie program cost and co pays the rest was paid by insurance co.

[Pam2011 26]

Health Alliance IL started covering the sleeve surgery last Fall. They also stopped requiring the 4 out of 6 months weight loss visits to your PCP but Memorial Bariactric services still requires that.

I almost switched health insurances last year due the IL state mess with health insurance but in the end they left Health Alliance continue their contract.

I have had to pay the usual co pays for PCP monthly weight loss visits, one copay for my pysch social visit and I think $0 co pay for the nut. visits. I will have to pay a $250 deductable for the surgery and hospital stay and then there is a $300 Springfield Clinic surgeon fee that I guess Insurance doesn't pay. I am not for sure what that fee is for but it was on my papers when I first started this process about insurance coverage. It looks like we have the same Dr! Have you been going to the local support group meetings? I have since Feb.

Nice to met someone near me!

Thanks!

A few years ago when I first started looking in Bariatric surgery I had Health Alliance and you had to complete the "new you" program, is that still one of their requirements? I switched last year to Health Link because the sleeve was not covered by Health Alliance. Aside from some out of pocket expenses ie program cost and co pays the rest was paid by insurance co.

[Condessa 3]

I've not made it to the support meetings but do want to go in May for the clothing exchange. I think the exchange is a great idea and hope to swap some work clothes out

[Pam2011 26]

I need to go through my closet and get rid of some of my too big clothes too even though I haven't had surgery yet I have clothes that are too big due to loosing weight pre op. I hope to see you there! It's great meeting someone near me that is on this list!

I've not made it to the support meetings but do want to go in May for the clothing exchange. I think the exchange is a great idea and hope to swap some work clothes out

[Pam2011 26]

Just an update on my insurance Health Alliance Illinois. My paperwork was sent in on 4/13/12 and there was a checklist from my PCP missing so they had to get that and I was approved on 5/8/12. My surgery date is June 11th. My nut. said Health Alliance is one of the better insurances and covers most everything. I have only had to pay co pays of $20 to my PCP for 4 weight loss visits (not required by my insurance but by my bariatric program) one $20 co pay for my psych visit, all my nut. classes and appointments were covered with no co pays. All my labwork is covered 100%. I will pay a copay of $250 for the surgery/hospital stay and a $300 surgeon fee that Springfield Clinic charges that my insurance won't pay. I am not for sure what the $300 fee is for and have a phone call into Springfield Clinic about that. So out of pocket I am out about $650 for this process. It helps that my bariatric programs surgeons are listed in my network as the hospital is too. I was worried that my insurance might be changing due to open enrollment that is right now but the state did go into a 90 day contract with Health Alliance IL so I know I will still keep it till they say otherwise. I am thankful I have insurance and my employer pays for it for me!

Count down is now on liquid diet that starts May 28th and surgery date June 11!

Nervous and excited both!