Looking for good insurance in CA

[Shelia 0]

I am just starting my Quest toward surgery. I live in southern CA and own my own business. I am shopping for a group plan for me and my employee and would like to know if anyone in my area has good sucess with a particular carrier. I appreciate any info I can get.

Shelia

[QTkidsmom 0]

BC of California paid for my surgery. Reading the posts it appears that they have a good rep for doing so...

Hope that helps!

[Shelia 0]

<p>Thanks for the reply, do you mind if I ask which plan you have , HMO, PPO etc.?</p> <p> </p> <p>Thanks again,</p> <p> </p> <p></p>

[Liz1531 3]

I am in San Diego and have Kaiser. I am not 100% happy w/ them. They pay for bypass but not lap band. My copay for having a baby is only $250

I am just starting my Quest toward surgery. I live in southern CA and own my own business. I am shopping for a group plan for me and my employee and would like to know if anyone in my area has good sucess with a particular carrier. I appreciate any info I can get.

Shelia

[Vicki J 0]

Liz1531 - Kaiser in Northern California does pay for the lapband. They started doing the proceedure in February of this year. I live just out of Sacramento on the Reno side and have to go to South San Francisco for all of my appointments. So I know that only a few of the Kaisers do the proceedure. I have heard that the Long Beach Kaiser does the proceedure. But if you have some place that does the bypass they should do the band. When did you last check?

[Liz1531 3]

Kaiser here only pays for the Gastric Bypass. I just checked last week. They are taking names of patients interested in lap band as they are working on adding the service. However, the doctor in charge of this new program called me and already told me I don't qualify with a BMI under 40 or maybe it was 50??? My BMI is 39. Also, I don't meet the criteria for the bypass as I am a low BMI patient w/ no medical problems. It's a real bummer that if I just gain 50 pounds I can get the Bypass w/ a $250 copay but without the extra weight they won't do anything for me.

[Vicki J 0]

Yeah, I know what you mean. It's really sad when you're "lucky" enough to be obese enough. Have you ever thought of putting quarters in your pockets?

[iluvlongnecks 0]

I am with Kaiser also and am trying to get a lapband, only I just got started and my doctor has referred me to SF to see if I'm a candidate. I have a BMI of 37, but beacause I have sever sleep apnea my doc refered me. By what I'm hearing from other's it don't seem like I have a good chance to get approval.

[DropOut 0]

I am currently going through the 24 session bariatric surgery class in Fontana Calif for bypass surgery. Kaiser has approved the lapband surgery here as of a couple months ago. It is done in Long Beach but you still have to go through the 24 week class , psych eval etc first. I am wrestling with myself over which procedure to choose and am leaning lapband even though it appears to be rather troublesome. I can always convert to bypass surgery later if complications cause removal.

[iluvlongnecks 0]

I got my letters yesterday from SF to get my blood work done and the form to give to my dr. to order the EKG and Chest X-ray (took care of that today). I am scheduled for Sept 11th to go to SF for my orientation,psyh eval and dietary eval. I'm looking forward to this journey to SF and I'm praying that this is the start to being a healthy me again.

I know that I haven't been approved yet and still need to jump some hoops to get it. I pray this works out for me!

[Shelia 0]

Drop out, how is it going? And who is your Primary physician? Mine is in Claremont and I just finally got assigned to her. I am going to approach her about Bariatric next visit... any advice?

[iluvlongnecks 0]

It's been a couple months since I've been on here and posted anything. Let me first say that I went to my orientation on 9/11 in SF and was told that it would be another 16 weeks till I got my next appt. and they told everyone in the room that we had to lose 20 lbs.....I lost the 20 lbs in 12 weeks, but now that I've been going through the holidays and with all the sweets that go with it, I think I've gained about 3-4 lbs YIKS! I was doing a lot of walking and have slacked off of that too with all the colder weather we've had and my knees starting to bother me.

It will 16 weeks on Jan 11th and I have not recieved any word in regards to my next appt.....so I'm thinking that I should give thema call here pretty soon and look into whats going on in regards to that. I surely don't want them to forget about me.

I'm not in such a rush as I was before due to the fact that my family just learned that my step-mother, who I am close to has cancer and will not have long to live. My husband and I are moving my parents in with us, as we have in-law quarters. Moving them here to Sacramento from Oregon will make it easier for all of us kids to help take care of her.

She is the one person who totally supported my decision to go through with getting the lap band and now she won't be here to see it happen and to see me lose the weight that I so want to lose.

[destined2befree 0]

Hi, i live in Orange County and we have blue cross HMO--I went to my first meeting 11/14 and my surgery is on 01/07/08---my BMI is 38. BC of California HMO is paying for all of it, i paid $137.50 and that is all....best deal in town! Last year we had BLue cross PPo and they were gonna pay for it but our out of pocket cost was going to be $8K...not such a good deal for us...check it out...and good luck. I have 8 more days before I join the BAND wagon... :clap2:

[Jacque411 0]

I live in southern Cal and I have New Herizion medical. Its government issued insurance. Does anyone know if they cover the lapband? Im new to this and read something that medical covers the lap band. Any advise?

[coltonwade 27]

Shelia

One thing in checking into insurance, I just went through this , i knew it coudl be an obsticle prior to surgery ,,,, Private pay insurance is NOT the same as group plans . the policies that are saying they had their insurances pay for the band are they private pay polices or group plans ?

Also get insurance if you can prior to surgery and once you get it do not let it go. I dont know about CA but in texas most of the insurance compaines once they find out your banded your no longer insurable. They will permanatly deny you . I could not get insurance before the band due to my weight, NOW i cant get it because of the band. Before surgery i got on Texas' high risk health pool I pay $309 a month for just MYSELF .

Group plans are different , they dont deny you for things , private polices can deny you for anything. So while your looking say nothing to the insurance or your docs about surgery ! That way nothing is on your records about it prior to getting the insurance !

Feel free to email me if you like , this whole process was a pain for me , im also self employed.

HTH

Mindy