Question related to 6 month waiting/nut/test period etc......

[Megan00 38]

Hi

I have so many questions after my 1st consultant & would love to no if anyone experience this:

1st seems like I will be all over the city trying to get all these requirements meet ( I thought it was something they do in the office).

2nd I was given a packet (wellness program that is require) which cost $730.00 + $285.00 for (wellness consult)

$300.00 for the Optifast Pre surgical liquid diet Program not to mention the Vitamins

Milti-Vitamin, calcium citrate chewables, sublingual B12 $86.00 (this is for post op)

Has anyone experience this ?

Did you have to pay for your classes or were they included?

FYI- I have to wait 6 months so basically it looks as I am paying for the 6 month supervised medical weight lost program

[mtnhomeeee 27]

you can get the Vitamins and B12 sublingles cheaper at walgreens

[macman 603]

I had a six month managed plan required by insurance however it was different than you are experiencing. BCBS of Illinois required that I go to a Bariatric Center of Excellence. Since there was only one in Central Massachusetts choices were limited, but it was a terrific program. I did have to pay a $300 program fee which supposedly covered materials.

It was a hospital run program so any testing was set up for me and was done right in the hospital. I had to get blood testing, a pre surgery physical clearance and an upper GI. All taken care of by insurance since I had met my deductible. I was never asked to buy anything from them. My personal opinion is that was a good idea because they let me make the choices for myself and I think it did not prevent them from recommending a wide variety of brand name products because they weren't selling anything themselves

The six months does get long. I was very ready after 4 months for the surgery. I think the time can be used to establish routines you will use after surgery, try different foods and Protein sources, especially all the different kinds of shakes. The NUT put me on a 2000 calorie diet that I reduced myself over time. The exercise physiologist helped me start an exercise program. I lost 42 pounds during the process and felt very ready for surgery.

[beckyloo4 40]

I had a six month managed plan required by insurance however it was different than you are experiencing. BCBS of Illinois required that I go to a Bariatric Center of Excellence. Since there was only one in Central Massachusetts choices were limited, but it was a terrific program. I did have to pay a $300 program fee which supposedly covered materials.

It was a hospital run program so any testing was set up for me and was done right in the hospital. I had to get blood testing, a pre surgery physical clearance and an upper GI. All taken care of by insurance since I had met my deductible. I was never asked to buy anything from them. My personal opinion is that was a good idea because they let me make the choices for myself and I think it did not prevent them from recommending a wide variety of brand name products because they weren't selling anything themselves

The six months does get long. I was very ready after 4 months for the surgery. I think the time can be used to establish routines you will use after surgery, try different foods and Protein sources, especially all the different kinds of shakes. The NUT put me on a 2000 calorie diet that I reduced myself over time. The exercise physiologist helped me start an exercise program. I lost 42 pounds during the process and felt very ready for surgery.

I have BCBSIL also. I have a surgery date of March 13th and start my 2 week liquid diet tomorrow. BCBS received my paperwork from my physician on Monday, the 24th, for final approval. How long did it take before you found out you were approved?

[cinthysline 20]

costco also has great prices on Vitamins and B-12.

[macman 603]

BCBSIL told me they had 30 days to approve, but it only took 15

[readyanxiousscared 57]

I have BCBSIL also. I have a surgery date of March 13th and start my 2 week liquid diet tomorrow. BCBS received my paperwork from my physician on Monday, the 24th, for final approval. How long did it take before you found out you were approved?

Beckyloo4,

What institution are you using? Where are u in this process? Please tell me more as. I too have BCBSIL and am using UIC.

[readyanxiousscared 57]

BCBSIL told me they had 30 days to approve, but it only took 15

Macman,

How did that work, Have BCBSIL and having the procedure done in another state? I'm slightly confused on the deductible and am not sure what I will have to pay out of pocket.

[beckyloo4 40]

Beckyloo4,

What institution are you using? Where are u in this process? Please tell me more as. I too have BCBSIL and am using UIC.

I am going through Geisinger, a local hospital where I live. Im on my 2 week liquid diet with surgery scheduled March 13th. My doctor sent all my paperwork to BCBSIL this past Monday so I'm hoping at some point this week my surgery is finally approved.

[macman 603]

There was no problem at all with insurance. BCBSIL has been my insurance provider for a long time because of the group plan I belong to. It was accepted in Mass before ObamaCare and is fully compliant now. The blue cross Network is also accepted by most Massachusetts institutions. My plan pays 90% of costs after deductible is met. The deductible was $500

They had requirements like everyone else. I had a six month plan which the hospital worked with nicely. I also had to have surgery at a Bariatric Center of Excellence. That is why I went to UMass Medical Center. (This was also a personal requirement for me because I wanted to be in a major hospital, if something went wrong). They paid for all pre testing, done in the hospital. My surgery happened in December so I met my deductible before the surgery. I just had to pay the 10% the insurance did not cover, which for me was about $2500.

I did return in. January with a complication and had to pay a $500 deductible, plus the 10% the insurance did not cover for another $6K.

[macman 603]

There were no problems with insurance. They are a long term provider for me. I belong to a group plan that has used them for years. They met mass health care requirements before ObamaCare and now are fully compliant with ObamaCare.

They required that I have surgery at a Bariatric Center of Excellence and required a six month managed plan. They paid for all pre testing. They did not pay for the $300 program fee.

I had surgery in December and had met my deductible, so my out of pocket was the 10% insurance did not cover ($2500)

I returned to the hospital with complications, so had to pay my deductible and 10% of costs ($6000).