mightyschratt 30 Posted January 11, 2013 Does anyone have any experience with this hospital based insurance company and gastric bypass? I work for a major hospital in their EMS (ambulance) dept. The insurance clearly states that it "does not cover weight loss surgeries, unless proven medically necessary by one's physician." I live in GA, and would love to hear some responses from people with encouraging feedback. Share this post Link to post Share on other sites
BBdoodle 483 Posted January 11, 2013 Most insurances say that "general" statement. Mine did (Horizon Blue cross blue shield), my surgeon's office/staff knew exactly what my insurance required to get approval. My BMI was 36 which was boarderline for surgery. My surgeon required that my regular physician submit a letter which they drafted stating why he thought I needed surgery. My physician was totally in agreement with me because he has seen me be on a roller coaster with my weight for the past 20 yrs. So he gave me the drafted letter to submit to the ins. co. along with that my blood pressure was steadly increasing and my chloesterol was 210. So I was boarder line on the comobilities (sp) and hand only 70 lbs to lose. I thought that I would not get approved but I did, I did not have to do any pre-op diet or anything. You surgeon should know or do research on exactly what you ins. co requires etc. My surgeon's staff was well educated on what each ins. co. required to get approval. Share this post Link to post Share on other sites
Debbiebydesign 93 Posted January 12, 2013 I work for a hospital. My insurance covered it based on letters from my doctors regarding medical necessity. Share this post Link to post Share on other sites