NewHealthy 0 Posted June 14, 2015 I'm new here and just beginning to look into have the procedure. Just had my physical and Dr. suggested and gave me a Bariatric Dr. referral. I have no idea if my insurance will cover this. I was interested to see if others have the same insurance and were covered. Been trying to read as much as possible about the procedure and the wait time. Is it possible for a shorter wait period before approval? Share this post Link to post Share on other sites
kbingo 24 Posted June 14, 2015 Hi, I am still new to all this (I am going to my second seminar next week, hope to get sleeved in October of November) but what I have found out so far is each insurance is different. If you have BCBSNC you can go online and look up your coverage or you can call and they can tell you exactly what is and is not covered. I have BCBSNC thru my employer (they are self insured) and several ladies at work have had both the bypass and sleeve done so I know my insurance covers both the bypass and sleeve with the only requirement being BMI over 40 or 35 and co-mobidity, no diet, no previous record of weight loss. I think they require at least one meeting with nut but that's all. Good Luck Share this post Link to post Share on other sites
NewHealthy 0 Posted June 14, 2015 Hi, I am still new to all this (I am going to my second seminar next week, hope to get sleeved in October of November) but what I have found out so far is each insurance is different. If you have BCBSNC you can go online and look up your coverage or you can call and they can tell you exactly what is and is not covered. I have BCBSNC thru my employer (they are self insured) and several ladies at work have had both the bypass and sleeve done so I know my insurance covers both the bypass and sleeve with the only requirement being BMI over 40 or 35 and co-mobidity, no diet, no previous record of weight loss. I think they require at least one meeting with nut but that's all. Good Luck Thanks, kbingo I have looked and it's so confusing to me. One place it looks like no it's not covered and reading in another area it looks like yes they do. I am planning on calling hopefully soon. I'm covered by my husbands policy as I work part time, but part time feels like full time some weeks. That would be great if it held true for me on no previous records etc. I have tried WW and other plans but did not keep anything to show proof. Plus my husband is planning on retiring soon and I would not have 6 months possibly. Thanks again! Share this post Link to post Share on other sites
queencity 62 Posted June 14, 2015 I have bcbsnc and I am covered. Just have to make sure I am approved. It depends if his employer opted out of weight loss surgery coverage or not. Bcbsnc generally approved weight loss surgery only of his employer chose that with their plan. Keep me posted, I have my appointment with the surgeon June 17 so if I know something else I'll mention it here. Share this post Link to post Share on other sites
NewHealthy 0 Posted June 15, 2015 Thanks, queencity I hope to call this week or next. Share this post Link to post Share on other sites
NewHealthy 0 Posted June 16, 2015 Talked to the insurance company today and they will not cover the surgery only 4 Drs. visits and an evaluation for treatment. Sad Share this post Link to post Share on other sites
JessyPessy86 0 Posted July 16, 2015 I am covered under my husband's BCBSoNC state health plan and spoke to a rep for the insurance company. She said that for us, under the 70/30 traditional plan, there's a chunk out of pocket and that there shouldn't be many problems as long as I have the surgery done at a Blue Distinction Center+, which for me means New Hanover Regional. I wish you guys the best! Share this post Link to post Share on other sites
queencity 62 Posted July 17, 2015 Jessypessy86 has your surgeon told you about how long an average does it take them to do the surgery? I plan on getting the bypass, what about you? Share this post Link to post Share on other sites
NewHealthy 0 Posted July 19, 2015 I am covered under my husband's BCBSoNC state health plan and spoke to a rep for the insurance company. She said that for us, under the 70/30 traditional plan, there's a chunk out of pocket and that there shouldn't be many problems as long as I have the surgery done at a Blue Distinction Center+, which for me means New Hanover Regional. I wish you guys the best! Interesting we have a PPO though them and I was told no surgery is covered for bariatrics. I called the surgeons office and they were going to look into it and never got back to me. I think they lost my number and I have not had the time to call them with work right now. They close most days at 6 one day at 6 with no weekends. Share this post Link to post Share on other sites
JessyPessy86 0 Posted July 19, 2015 Queencity- I haven't spoken to the doctor yet, but it takes an average of 3-4, sometimes 5 hours. It shouldn't take longer than that. I am planning on the vertical sleeve for now. NewHealthy- I am not sure how mine would be covered and your won't, but maybe it's an employer thing? My hubby works for our county's schools. I would pester and pester that office. Share this post Link to post Share on other sites
NewHealthy 0 Posted July 19, 2015 Queencity- I haven't spoken to the doctor yet, but it takes an average of 3-4, sometimes 5 hours. It shouldn't take longer than that. I am planning on the vertical sleeve for now. NewHealthy- I am not sure how mine would be covered and your won't, but maybe it's an employer thing? My hubby works for our county's schools. I would pester and pester that office. JessyPessy86, I just may do that in a couple of weeks when I retire. Hopefully my husband will not retire right after me as we will have to look for insurance for me. Wonder if that would be harder to get approved with a new insurance. I would love to get off my diabetic meds and a couple of others. Share this post Link to post Share on other sites