Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Insurance changed!



Recommended Posts

My insurance changed! I started my journey November 2018, with a consult with my (then) surgeon at Riverside Medical Clinic. With my (then) insurance, Anthem Blue Cross ***, I only needed 3 month (12 continuous classes) supervised nutrition/weight classes. As of now, I finished 10 out of my 12 classes. Last week I found out my insurance changed to Anthem BC PPO and they now require me to go to a Dignity Health Facility to be covered 100%. Well okay... I call my nearest Dignity Health bariatric surgery center to find out more.

I was told at Western Bariatric (St. Bernadine -- San Bernardino, CA) that I needed 6 months of classes and basically restart my journey. I started to bawl my eyes out! I'm 25 (November birthday) and I'm getting real close to end of my insurance coverage under my parents. When I had started my journey, I was hoping to have my surgery by March or April. So, I'm worried about having my surgery before my cut off. Anyway, I sucked it up and started making calls. I attended their Seminar, where we filled out new patient packets and made copies of our insurances.

The next step is to wait for a call to schedule my consult with their surgeon. I was told that the consult would count as 1 of the 6 months of weight classes.

Does anyone believe they will accept my 3 months of classes Ive already taken? (and maybe only need 3 more months to meet the 6mo requirement?)

Will they consider the original surgeon consult from November 2018 too (as part of the 6 months wight management?)

I'm honestly hoping that Western Bariatric will consider my start (Nov.) to my current (Feb.) for a total of 4 out of the 6 required months. I didnt want to be set further back, but ill take whatever they'll take and Im hoping for the best!

Can anyone can give me some insight? Similar situations? Anyone go to Western Bariatric? I'm really anxious.

Share this post


Link to post
Share on other sites

I have zero insight on your insurance issue but I just wanted to say I’m sorry for your setback. I will say I went through an extensive program to be prequalified for my insurance. And when I finally went to the surgeon I still had to do all their requirements which is an additional 3 months. So they may want you to check all their boxes but I hope not. Good luck!!

Share this post


Link to post
Share on other sites

Oh that's a shame. It seems like they'd count your already completed 3 months of classes as long as they were consecutive without gaps. I had to wait an extra 3 months because my insurance was changing and I didn't have time to get six months of supervised medical weight loss management under my prior policy and my new policy didn't require it.

Share this post


Link to post
Share on other sites

Why are your insurance companies so mean with so many hoops. You pay for a service from them they shouldn't ask you for so much

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • rlcpd

      Two months out from hiatal hernia repair.  Surgeon said to expect a lot more flatulence...something about the 'air' no longer being able to 'burp' out so comes out the other end.  That is my experience but have no understanding of why that swallowed air cannot be 'burped'. ???
      · 1 reply
      1. BlondePatriotInCDA

        As I understand it since your stomach is smaller and not completely resting against your diaphragm anymore you no longer have the ability to "push" burps out as well. Plus, since its smaller and we don't digest slower the trapped air moves a lot quicker out of the stomach so its no longer available to burp out. Hence the other option for removal.

    • Lizette1122

      Anyone had the TORe procedure? How did it go? How much weight did you loose? 
      · 0 replies
      1. This update has no replies.
    • LadyVeteran1

      Sleeve surgery is on April 14th.  I am counting the days!!  Can't wait!
      · 3 replies
      1. Brookie2shoes

        Me too girl!! Are you in the full liquid diet right now? It’s sooooo hard!

      2. LadyVeteran1

        Not yet. I was told I only have to do 24 hours of a liquid diet. But I have my pre-op tomorrow so I’m going to confirm if I need to do longer.

      3. buildabetteranna

        Your so close now! It's gonna be great :) Wishing you a speedy recovery and looking forward to seeing how it goes!

    • buildabetteranna

      Down 33 lbs and slightly stalled, but I'm gonna reevaluate and push through. I started back to work last week after 2 years of being disabled due to mental health as well as my weight. It's a great job and I'm just so happy to have this opportunity at a second chance at life. Hope everyone is having their best journey ❤️ Together, we got this!
      · 2 replies
      1. DaisyChainOz

        Great work Anna! Keep it up 😁

      2. buildabetteranna

        Thank you ❤️

    • Bashbee91

      Hey guys new to the process looking forward to this new life. 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×