CDPHP Insurance Question & Saratoga Bariatric Center Question

[ShutterGirl1829 41]

Hi! I just decided a couple of weeks ago to start this journey, although it is something I have considered for many years. I have my 1st informational session on July 14th and my initial consultation at the Saratoga Bariatric Center with Dr. Baranov on August 11th. My 1st question is, does anyone have any experience with CDPHP during this process (I have a very general policy.. EPO National, no deductibles co insurance etc.), do they require the 3 month diet etc? I was also wondering how long the process was from your initial consultation to the day of surgery?

My next question has to do with Saratoga Bariatric Center. How was your experience with them?

Thanks in advance!

[red37 116]

Hi, I have CDPHP also EPO, but do have deductibles (Utica area surgeon). The process was actually really easy for me. My surgeon's office did all of the paperwork, approval process for me. So much so that I called several times saying "are you sure I don't have to do anything else" and they always said yep, you are fine. I did not have an insurance mandated pre-op diet, just a 2 day liquid diet from my surgeon. It may have to do with our pre-existing conditions too though, not sure. You can call CDPHP and ask them how much it will cost you-that was an easy call. My consultation was the end of January and my surgery was May 28. It could have been in April, but I wanted to wait till had I a lot of time off a work. The time in between was spent on a visit to my GP, an endoscopy, several different blood tests, h-pylori test, psych visit, nutritionist visit, pre-op testing, and maybe one other thing.

Good luck!!

[ShutterGirl1829 41]

Thanks for the reply! I have made the call to CDPHP and inquired about any diet guidelines they had as well as cost. Basically I was told they don't have any diet guidelines and that my only OOP costs would be my $15 copays for my consultation and any other visits like that and a $250 inpatient copay. Thank you for all the info, it is greatly appreciated and helps me to get a grasp on what types of appointments I can be expecting.

[TarponRN 0]

I have CDPHP also and had my surgery with Dr. B. The office does all the leg work for you. Dr. B dictates if and how much weight you must lose. CDPHP does not have a requirement. Dr. B. is very strict, but it works. I was sleeved on July 6th and I am down 19 lbs already amd feel great! Good luck!

[ShutterGirl1829 41]

Thank you so much for the reply. I had my initial consult with Dr B. A week ago today and he told me in order to get the bypass instead of the sleeve, he would like me to lose 30-50lbs before surgery (which is set for 9/21). He put me on a diet of egg and toast for Breakfast, atkins/smart one etc for lunch and one for dinner. I thought he was absolutely insane but so far I am down just over 17lbs in a week.. So I can't complain... lol

[SuzzyQ_delli 35]

Was your CDPHP insurance Medicare or Medicaid? Mine in neither and I am so afraid they will not cover it???? This is what I have:

CDPHP EPO Hybrid 204 Gold

[ShutterGirl1829 41]

I had CDPHP EPO not medicare or medicaid and CDPHP in general covers bariatric surgery with tge only requirement being a psych eval and meeting with a nutritionist. No extended diet plan etc... I had my initial consult with my surgeon on 7/17 and surgery less than 2 months later and the only reason it took 2 months was because my surgeon wanted me to lose 50lbs before surgery, and i thought 2 months woyld be enough time

[SuzzyQ_delli 35]

What were their requirements as far as BMI and comorbidities? I have a BMI over 40 with none. Thanks so much for your help I've been getting very discouraged lately when it comes to the insurance.

[ShutterGirl1829 41]

If you have a BMI of 40 you need to have at least 2 comorbidities but 60 and over you don't need any. The surgeons will usually work with you to find comorbidities in order for you to qualify.