Partnership insurance of califonia thru medi cal

[collinsmix 5]

Does anyone have this insurance I have alit of questions my insurance won't answer

[2goldengirl 2,076]

What county are you in, and are you part of a County HP, or a Medi-cal managed care plan, for example, Blue Cross Medi-Cal?

[collinsmix 5]

Hi im in sloano county I think its thru sutter hospital ???

[2goldengirl 2,076]

The page with the specifics about bariatric surgery won't load, but your member's handbook does say that surgeries (other than emergency) require prior authorization.

You don't mention your BMI or any other medical problems you have. What sorts of questions do you have?

[jessicabell620 2]

i have medi cal.. with community health group.. has anyone been denied the surgery part? i was approved for the consultation

my bmi is 52

pre diabetic

back pain

sciatica

depression

sleep apnea (not diagnosed)

hypertension

[2goldengirl 2,076]

With a BMI of 52, you will qualify in terms of BMI. Call and ask what other requirements need to be met, Your PCP's office will be able to help you with this - that's where you start. The county plan may have other requirements, including assessment by a Registed Dietician and a psychologist. They may require that you follow a plan monitored by either your PCP or the dietician for a period of time.

You will need to attend an orientation session and you may have to travel out of county for visits to your surgeon and your surgery.

Your PCP will be able to tell you which surgeon(s) are part of your network. The surgeon's office will be able to tell you at which facility they do their surgeries.

Yes, some people do get denied, but the most common reason is for low BMI, You won't be. Just follow the requirements and you should be fine.

Good luck!

[collinsmix 5]

Thank u for all the info my bmi 44 I have high cholesterol back and knee pain I have my first appt. With my pcp on friday my insurance told me yes bariatrics are covered just has not toln me the requirements they told the the hospital where I can go and sent me a new pt packet I will be attending a seminar next month only thing missing is a referral from my pcp. I rarely see my dr. Because its a community health clinic usually see a nurse practitioner and she is very supportive of wls but can't refer me I pray my dr will be as supportive