Nervous about insurance

[ZGal 84]

I have Anthem BCBS in CT. I’m down to my last nutrition appointment in a couple of weeks, and then scheduling my surgery! However, I’ve gained weight (about 10lbs) during my nutrition visits over the past 5 months. There’s no excuse for it, some visits I had lost weight, and others I had gained. I am really worried I’m going to get denied. Has anyone had experience with BCBS in CT? I know some insurances are stricter than others...

thanks in advance!

[anonbaribabe 236]

Even with the same insurance provider, policies can vary. Are you required to lose weight in order to be approved? This is typically information that your surgeon's office gets from your insurance provider, so I would check with them. You can also check with your insurance provider, but I've personally had issues with customer service reps giving out bad info. If your policy doesn't require any weight loss or exclude you from approval for weight gain, it shouldn't matter. You may also want to ask your surgeon if he or she will do surgery if you've gained weight, as some surgeons won't.

[lifeasfaith 48]

Even with the same insurance provider, policies can vary. Are you required to lose weight in order to be approved? This is typically information that your surgeon's office gets from your insurance provider, so I would check with them. You can also check with your insurance provider, but I've personally had issues with customer service reps giving out bad info. If your policy doesn't require any weight loss or exclude you from approval for weight gain, it shouldn't matter. You may also want to ask your surgeon if he or she will do surgery if you've gained weight, as some surgeons won't.

That is ABSOLUTELY true. Same insurance provider does not equal same coverage. I have United healthcare but mine is a Medicare advantage plan so my plan has to follow the criteria that Medicare follows by law which means I don't have to do 6 months worth of weigh ins with a Dr. Others have United healthcare through a work plan and they DO have to do a 6 month supervised weigh in plus other hoops to jump through. What I find infuriating is my health insurance was very secretive about what the criteria was for me to get bariatric surgery. They absolutely would not tell me. They gave me the number for member services and said my Dr would have to call member services that I couldn't call myself. They wouldn't even tell me if the surgery was covered! Are you serious??!! You mean to tell me you can't tell me what my benefits are!!?? The best advice is to work with your clinics insurance coordinator to get the info u need. They know how to navigate the insurance company.

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