Does anyone have Humana

la8again · January 24, 2008

Hi, I have Humana and I am wanting to know long it took to get your approval. Or if you did not get yours approved, why not? I will be submitting for approval in about 2 weeks after my phys eval is completed. I go on Monday the 28th, but then they have go over it so it will be a few days after. So I am hoping I can kinda know what to expect from them. Thank you in advance for any help!

Busy · January 26, 2008

Ashlee, I also have Humana. (KY) When I orig. submitted my info for approval, info on the lapband was just beginning to surface. I am assuming with the focus on diabeties, besity and childhood obesity in the US, then medical news reports documenting that weight loss surgery such as lapband is working, the insurance companys are finally getting with the program. With that said, I was in the process for a long time. Submit your info, jump through your hoops, and DO NOT GIVE UP. I have read on this forum where some Humana clients were approved withing 6 weeks and some may take longer. I was finally approved in December and now I am waiting for my surgeron to see me and set up a date. Anything worth having..........

PA

cierra'sgrandma · January 29, 2008

My insurance is Humana Private Fee for Service. They have a bariatric division. It really didn't take too long for me to get approved, once all the paperwork was submitted. I've already seen my surgeon, but had to wait for insurance approval before I could set a date for the surgery (February 6th) and start on the two week liquid diet. Due to insurance guidelines, I will have to stay overnight, but that's okay. My overall co-pay isn't bad, either. Just let me add this--don't take it for granted that you know what's covered and what's not {co-pays, etc.). Make calls if you have to, and don't give up, especially if you're truly serious about having the Lap-Band surgery. If anyone of you out there is on Medicare, they WILL cover the surgery, but there are a lot of hoops to jump through. One of their requirements is that the hospital you are going to have the surgery at be approved as an American Bariatric Center of Excellence hospital. PLUS--they will require you--if you are a smoker--to stop smoking. There will actually be a blood test done--either a number of days before your surgery, or the day of: I don't recall exactly--that will let your surgeon know whether or not you've been smoking. If you test "positive", your surgery will be cancelled. I don't think this takes second-hand smoke inhallation into account, and I don't know of further ramifications of a positive "smoker" test, but I'm sure they're out there.There are more requirements, and I am sure that there's somone "out there" in the lap band community who knows more than I do about this, and I welcome their input.

la8again · January 29, 2008

The COE is also a new humana policy. I am now having to switch surgeons due to the policy change on 1/1/08. I was just worried that it would takes weeks to get the approval done. Thanks for your input!