*Misty*Raine* 192 Posted July 8, 2014 Misty- thank you for the information. I will most certainly put a folder/binder together. Wow, July 15th isn't that far away. Congrats!!! What surgery are you having and what criteria did your insurance have? I have UHC choice plus so I'm hoping the three month program will be sufficient and not have to do the six months. I would get the surgery today if I could. How long has your process taken? I started my process 1/13/14. I had Molina. They made me do 6 mo program. Caresource is 9 mos. So check with the number for client services on the back of ur card for their requirements. And a tip I had to find on my own....open enrollment is coming up for insurance!! I changed mine to better suite surgery. Even tho it took 6 mos...it has been a journey. It is a great program with lots of info coming ur way. (Reason for suggesting the binder) I got tons of handouts....that I still refer back to. I am so excited to be in the home stretch now....headed to the losers bench in a matter of a week!!! so excited!!! Please let me know if I can help with ur journey in the future.....its great to have info and a helping hand along the way!!! Share this post Link to post Share on other sites
Jenn B. 4 Posted July 8, 2014 Good for you and congratulations. Please keep us posted on your progress. Share this post Link to post Share on other sites
Jenn B. 4 Posted July 8, 2014 Misty- I have United health care thru my husband work. I also have to do six months but I have been seeing a diet doctor every other month for the last fourteen so I'm hoping insurance will allow that as some of my time. Regardless I have to go thru my surgeons program for three months. I made my notebook up last night and started writing down some questions I have. Also received my health packet from clinic and filled it out yesterday. Hoping and praying they can get me in sooner than my scheduled appointment. The sooner the better. I'm so excited for you and thank you for your support. Good luck to you!! Share this post Link to post Share on other sites
*Misty*Raine* 192 Posted July 8, 2014 Misty- I have United health care thru my husband work. I also have to do six months but I have been seeing a diet doctor every other month for the last fourteen so I'm hoping insurance will allow that as some of my time. Regardless I have to go thru my surgeons program for three months. I made my notebook up last night and started writing down some questions I have. Also received my health packet from clinic and filled it out yesterday. Hoping and praying they can get me in sooner than my scheduled appointment. The sooner the better. I'm so excited for you and thank you for your support. Good luck to you!! Ty so much! If u have any questions.....hit me up. I have learned so much with dr custars team. Theyre brilliant. Share this post Link to post Share on other sites
Jenn B. 4 Posted July 8, 2014 Thank you. I can't wait to meet all of them!!! Share this post Link to post Share on other sites
lulabelle607 24 Posted July 8, 2014 I started my process 1/13/14. I had Molina. They made me do 6 mo program. Caresource is 9 mos. So check with the number for client services on the back of ur card for their requirements. And a tip I had to find on my own....open enrollment is coming up for insurance!! I changed mine to better suite surgery. Even tho it took 6 mos...it has been a journey. It is a great program with lots of info coming ur way. (Reason for suggesting the binder) I got tons of handouts....that I still refer back to. I am so excited to be in the home stretch now....headed to the losers bench in a matter of a week!!! so excited!!! Please let me know if I can help with ur journey in the future.....its great to have info and a helping hand along the way!!! So good to see someone with Molina got approved! Did you have any comorbidies? I don't have any but I've been overweight for 20 years and have a bmi of 56. I'm really sticking to my pre op diet and doing everything my drs office is telling me, but I'm still so worried I'm doing all of this just for a denial. Share this post Link to post Share on other sites
Jenn B. 4 Posted July 8, 2014 If Molina covers it and your are doing all the requirements then I don't see why they would deny you. Share this post Link to post Share on other sites
NicoleSW 78 Posted July 8, 2014 I'm hoping to get the RNY in early October. I'm having my surgery at Riverside in Columbus with Dr. Rana. I'm really loving the program so far. Everyone is so supportive and they call you back super quick. Share this post Link to post Share on other sites
*Misty*Raine* 192 Posted July 9, 2014 So good to see someone with Molina got approved! Did you have any comorbidies? I don't have any but I've been overweight for 20 years and have a bmi of 56. I'm really sticking to my pre op diet and doing everything my drs office is telling me, but I'm still so worried I'm doing all of this just for a denial. I did have comorbities. But.....I also had a bmi of 36. I think its anything over 40 they cover. I had to have a list of my morbidities and add to my bmi cause it wasnt high enuff.....but I also have 3 lung diseases and require alot of steroids. Dont sweat molina..... pqm is really good about getting it all approved. She would tell u if she couldnt do it Share this post Link to post Share on other sites
angelvsg14 0 Posted July 10, 2014 I am in cleveland I have caresource now but come oct I plan on switching to molina ( bmi 44) no comorbities. Don't really have a pcp but been going to a dr for a diet program past 2 months. How can I go about finding a bariatric dr and can I start my 6 months with caresource now and switch at open enrollment Share this post Link to post Share on other sites
Jenn B. 4 Posted July 10, 2014 I would check with Molina and see what the qualifications are. If you have to do six months then yes I would start now and make sure it's doctor monitored or it won't count. Share this post Link to post Share on other sites
Jenn B. 4 Posted July 10, 2014 You can google bariatric doctors in your area but you may need a specialist referral depending on your insurance.i would do my own research before I decided on a doctor. Check credentials and ask lots of questions. Share this post Link to post Share on other sites
kpenney727 2 Posted July 10, 2014 I am in cleveland I have caresource now but come oct I plan on switching to molina ( bmi 44) no comorbities. Don't really have a pcp but been going to a dr for a diet program past 2 months. How can I go about finding a bariatric dr and can I start my 6 months with caresource now and switch at open enrollment What hospital are you planning on going to? I am a patient at the cleveland clinic and I have dr Schauer and him and his team are amazing!!! Let me know if you need any advice!! Share this post Link to post Share on other sites
lulabelle607 24 Posted July 10, 2014 I am in cleveland I have caresource now but come oct I plan on switching to molina ( bmi 44) no comorbities. Don't really have a pcp but been going to a dr for a diet program past 2 months. How can I go about finding a bariatric dr and can I start my 6 months with caresource now and switch at open enrollment I am in Cleveland too. I had caresource but the diet is 9months and it's impossible for them to approve. I'm at St. vincent charity hospital and can't rant and rave enough about them. I LOVE their team and feel so comfortable there. Look into a seminar! Share this post Link to post Share on other sites
*Misty*Raine* 192 Posted July 10, 2014 So good to see someone with Molina got approved! Did you have any comorbidies? I don't have any but I've been overweight for 20 years and have a bmi of 56. I'm really sticking to my pre op diet and doing everything my drs office is telling me, but I'm still so worried I'm doing all of this just for a denial. Molinas requirements are 3 comorbidities and a bmi of 30+ or a bmi over 50 and comorbidities no longer matter. You have to do 6 mo program. That consists of: 1. Classes (about 6-9 classes) 2. Psych eval 3. Nutritional appts (2) 4. Meet excersize coach and get measurements. 5. 6 mos of weigh ins 6. Submit to insurance and they have (by law...2 weeks.) I hope this helps. I had molina and got approved. Surgery is Tues. Let me know if u have any questions. Share this post Link to post Share on other sites