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Not getting a clear answer

Laura Lopez

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Laura Lopez    20

Laura Lopez
Posted (edited)

My guess is if the surgeon says you don't or do need something, the insurance has to go with it. The surgeon is suppose to be the medical expert

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I hope so. I asked him if this doesn't work ( insurance approval) how much does the procedure cost he said 18,000. I immediately thought Mexico, I will go to Mexico. Then he added but don't worry I don't see a reason why you won't get approved just wait till next visit! why do they make it so hard to get approved!

Edited by Laura Lopez

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Read2016    658

Read2016
Posted (edited)

This journey of getting approved is more complex than I could have imagined. When I began thinking about this I never consider the first step should have been to look at my insurance policy. I just figured if they covered it, it would be handled like they do with any other health issues.

I wonder if the surgeon spaces out these "approval" based on their schedule. I know the one I'm using said he is booked for two months.

I love Mexico but am too chicken to have my surgery there.

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Edited by nyteacher125

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kaitlynm    335

kaitlynm
Posted

I think they are just looking for a weight record, not supervised weight loss attempts. Have you been to see your PCP for a couple of years? That is who I had to get 5 years of records from for BCBS TX.

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Laura Lopez    20

Laura Lopez
Posted (edited)

This journey of getting approved is more complex than I could have imagined. When I began thinking about this I never consider the first step should have been to look at my insurance policy. I just figured if they covered it, it would be handled like they do with any other health issues.

I wonder if the surgeon spaces out these "approval" based on their schedule. I know the one I'm using said he is booked for two months.

I love Mexico but am too chicken to have my surgery there.

Sent from my iPhone using the BariatricPal App[/quote

I am too! At the beginning of my journey Mexico was my only option. But then I was told that medical also covers this procedure I was excited and decided that I rather wait 6 months. I feel more comfortable having surgery here in the states than going to Mexico.

Edited by Laura Lopez

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Laura Lopez    20

Laura Lopez
Posted

I think they are just looking for a weight record, not supervised weight loss attempts. Have you been to see your PCP for a couple of years? That is who I had to get 5 years of records from for BCBS TX.

I've had different pcps. I have turned in 2013, 2014, 2015. All different doctors.

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Laura Lopez    20

Laura Lopez
Posted

I was told something similar by BCBS - Told me my Dr would need to determine requirements for prior authorization. I could not get anything in writing other than coverage info.

Isn't it frustrating. [emoji16][emoji16][emoji16]

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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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      Question for anyone, how did you get your mind right before surgery? Like as far as eating better foods and just doing better in general? I'm having a really hard time with this. Any help is appreciated 🙏❤️
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      1. NickelChip

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        I had about 6 months between deciding to do surgery and getting scheduled. I came across the book The Pound of Cure by Dr. Matthew Weiner, a bariatric surgeon in Arizona, and started to implement some of the changes he recommended (and lost 13 lbs in the process without ever feeling deprived). The book is very simple, and the focus is on whole, plant based foods, but within reason. It's not an all or nothing approach, or going vegan or something, but focuses on improvement and aiming for getting it right 80-90% of the time. His suggestions are divided into 12 sections that you can tackle over time, perhaps one per month for a year if a person is just trying to improve nutrition and build good habits. They range from things like cutting out artificial sweetener or eating more beans to eating a pound of vegetables per day. I found it really effective pre-surgery and it's an eating style I will be working to get back to as I am further out from surgery and have more capacity. Small changes you can sustain will do the most for building good habits for life.

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        That sounds awesome. I'll have to check that out thanks!

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