Newbie needs advice

[Old self 16]

Okay....I'm trying to decide between paying cash for the sleeve at the KC bariatric center with blis "insurance" or spending the next 6 months on a dr supervised diet and hoping my blue cross insurance will then pay for the sleeve after ive completed the diet (they require the diet before consideration.)

I've spent the last year analyzing and altering my eating habits to assure myself that the surgery is something I can handle. Throughout this time, I didn't think insurance would cover it because my bmi is 38 and I had no comorbidity so i was prepared to cash pay. I have gone through my initial labs and was preparing to schedule surgery when I was diagnosed with high blood pressure, so now I'm wondering if my insurance will pay for it.

What would you do?

[C_TimesThree 64]

If you have a co morb insurance will cover it, why waste money that insurance you already pay for could shell out instead of you? The time on your supervised diet will fly by faster than you think. Even if I wouldn't have had insurance hoops to jump through it still would have taken 3-4 months to do the testing my surgeon required.

[rickyswife 41]

I agree, if your insurance will cover then by all means try to use it..... are all of your efforts documented by a Dr. you may be able to fast track it....

[Old self 16]

I guess I'm concerned that they could still decline it.

I'm fine waiting the six months...a little disappointed, but still fine and the diet could only help with my new eating habits. However, I'll be really upset if I wait six months and then am given the run around for another six months and/or they decline it.

If insurance says they cover the surgery can they opt to decline me because it is still more cost effective to cover my meds?

[angelamarie 0]

Your physician usually has a pre authorization person in the office that generally can help you get the answers you need

[SuNMooNStaRS816 423]

Does your insurance require you to have one or two comorbidities? And if only one are you on meds for the bp? I know every policy is different, but some require you to be on meds. It's like being pre diabetic or a diabetic whose disease is controlled with diet. My insurance doesn't consider it a comorbidity if you do not require medication for it. Call your insurance to find out the requirement for your plan. Then decide what to do. No reason to go through all the hoop jumping with insurance if it won't be covered.

[Oregondaisy 2,021]

Just call your insurance company. You can ask them the requirements you have to meet to have this surgery.

[BellaHugz 331]

I have to agree about calling your insurance. But if you are like me several phone calls in and no answer. So I decided to look on my insurance website under bariatric surgury and see what are the comorbidities requirements for you to continue on your path to being sleeved. Bookmark the page so you have a reference to go by. Good Luck!