Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Poll: insurance acceptance/denial



Recommended Posts

How did your insurance respond? It would be extra valuable if you provided any additional information about yourself: starting weight, comorbiditis, what they made you provide, etc.

Acceptance, no questions asked.

Acceptance, if you provide certain information.

Denial, but with ability to appeal. Acceptance following appeal.

Denial, with no ability to appeal, or you did and it did not work.

Edited by bangbangbarbie

Share this post


Link to post
Share on other sites

My starting weight was 300, comorbidities include sleep apnea, diabetes, high blood pressure, and high cholesterol.

My insurance submission included 6 months of documented physician-supervised weight loss (during which I lost nothing at all), summary of psych eval, 5 years of weight history, lab results, surgeon's recommendation, and letter of support from my primary doc.

Insurance accepted on the first pass, no questions asked.

Hope this helps!

Share this post


Link to post
Share on other sites

I have BCBS FL and my insurance shot me down from the start. I spoke with Customer Service, HR at my work, and our rep from BCBS and it all comes down to, if this surgery was the only thing that could save me from death.... they would still deny me. I was told I could appeal it but my rep has never seen someone get approved since they recently changed to the NO EXCEPTION rule.

Share this post


Link to post
Share on other sites

Acceptance, if you provide certain information.

I have Group Health through Microsoft and they wanted to know what other things I have tried and for how long.
My starting weight was 335, I have lost 21 on my own while trying out the diet I am going to be living on for the rest of my life. It has been a struggle but I am getting there. My comorbidities are sleep apnea, high blood pressure, herniated disks in my back, and asthma.

I put in my application and in two weeks was approve. I had to wait for a month for my pre-op packet to come in the mail. I had blood labs, a mental health eval, x-rays, a mammogram, respiratory appointments I had to do before I could get on the list. I did them all in one day a week later. I have been to the mandatory support group and next I will be meeting with the dietitian for a diet review. After all of that it is surgery time.

Share this post


Link to post
Share on other sites

I have Kaiser Permanente and it was approved first time around. They did have a year of data with nutrition, psyc, sleep study, blood tests, classes, etc.

Share this post


Link to post
Share on other sites

Acceptance, no questions asked.

Share this post


Link to post
Share on other sites

Approved with no questions...

Share this post


Link to post
Share on other sites

accepted first try no questions asked


Share this post


Link to post
Share on other sites

I was told by my insurance that if it is medically necessary (which it is), they will cover it.

Share this post


Link to post
Share on other sites

I was 248. Aetna makes you have 6 months of weight loss monitored by a doctor who has to ask about your diet and exercise. I was approved within hours of my paperwork arriving.

Share this post


Link to post
Share on other sites

I was 310lbs, a type 2 diabetic, sleep apnea, high blood pressure

I had to follow a six month physician monitored program. I had to work with a Bariatric Center of Exellence.

My paperwork was submitted and within 48 hours I had both verbal and written approval.

My insurance was Medica.

Share this post


Link to post
Share on other sites

Uhc cc approved

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Alisa_S

      Gearing up for my consult 01/14! Starting to get a little nervous.
      · 0 replies
      1. This update has no replies.
    • Goyafigs

      I had VSG 11.20.24 with Miguel Burch, MD Cedars-Sinai and I am 1 month post-op. 
      · 0 replies
      1. This update has no replies.
    • DaisyChainOz

      🥳 Jan 1 2025 - Day 1 of Pre Op, surgery on the 16th! 😬😅
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Just been waiting until time for my consult with my bariatric surgeon. It's scheduled for Jan 9th. Turns out I won't actually be seeing him. Apparently it'll be with his P.A.             Not sure what to expect. I thought this is where the surgeon would discuss the best surgery option for me. For years I had my heart set on the sleeve, but I've read so many people have issues with reflux - even if they've never had it before - that they've had to be revised to the bypass. I already deal with GERD & take 40 mg of Omeprazole daily, so I started studying about bypass and honestly, it seems like it might be the better choice for me. How can we discuss surgery options if the surgeon is not there?
      What happened at your first consult? Trying to get an idea of what to expect, or maybe I should say, what NOT to expect.
      · 0 replies
      1. This update has no replies.
    • rinabobina

      I would like to know what questions you wish you had asked prior to your duodenal switch surgery?
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×