Which insurance offers this surgery easily?

[Guest BikiniBeachy]

I just lost my insurance (which is fine) and will be picking out an individual plan. The bariatric surgery option is the number 1 in importance to me. Can someone tell me the company I should go for that offers this surgery with the least trouble as possible? Thanks. (I'm in Colorado, national company preferred)

[AAA022414 13]

I have united healthcare..i had to do almost nothing to be approved...all the insurance company required was a certain bmi, which i have no idea what that was since mine was at 47 that was plenty..anyway a certain bmi and a psych consultation. the doctors office required more. I work at wells fargo so i have uhc through them...apparently from what i've heard their plan is one of the best for this type of surgery...once i got through the stuff for the docs office they sent in the paper work to the insurance company and was approved within 3 days...i started the process on jan 12th and had surgery feb 28th. there's other postings on here that say uhc made them jump through all sorts of hoops to just be denied...so i guess it just depends on your certain plan...i would say get a job at wells fargo =)

[dyingbreed 1]

I have united healthcare..i had to do almost nothing to be approved...all the insurance company required was a certain bmi, which i have no idea what that was since mine was at 47 that was plenty..anyway a certain bmi and a psych consultation. the doctors office required more. I work at wells fargo so i have uhc through them...apparently from what i've heard their plan is one of the best for this type of surgery...once i got through the stuff for the docs office they sent in the paper work to the insurance company and was approved within 3 days...i started the process on jan 12th and had surgery feb 28th. there's other postings on here that say uhc made them jump through all sorts of hoops to just be denied...so i guess it just depends on your certain plan...i would say get a job at wells fargo =)

oh sweet, I work at Wells and I'm just starting to look into this procedure.

Which plan do you have through them?

[AAA022414 13]

i have the wells fargo healthplan...where do you live? i think health plans differ a little bit depending on the part of the country...i live in iowa...the wells fargo healthplan is the only one through uhc...i had conventry last year and they do not cover it...the process was super easy for me...i would love to know about your experience...please update me =)

[dyingbreed 1]

i have the wells fargo healthplan...where do you live? i think health plans differ a little bit depending on the part of the country...i live in iowa...the wells fargo healthplan is the only one through uhc...i had conventry last year and they do not cover it...the process was super easy for me...i would love to know about your experience...please update me =)

I'm in Florida, and I will keep you up to date. The office should be submitting for approval next week...... so we'll see:unsure:

[Wheetsin 714]

Bikini, you're just going to have to research your options. You've asked who excludes, but obviously we can't provide information on every option available to you, and it's the same with this question.

I would suggest making a list of what's available to you, and then go to OH. Somewhere at some point they had a list of patients and what insurance they had used. Go through that list and make a tick mark next to each of your options, and then count up who has the most tick marks.

Or, get your list of plan options, and start calling the providers and ask them if it's covered.

That's going to give you much, much more reliable information that we can. A "horse's mouth" kind of thing. As you'll see, your thread didn't go more than one post without diverging away from individual plans. Not only can most people here not tell you the difference, but they don't have them.

If you want someone to tell you what insurance to get (first of all, good luck), then you might want to rethink how you're going about getting your information. Maybe post a poll on type of plans, then when/if you have other individual plan users identified, follow up with them to see what they used.

[snuffy65 1]

Also, don't forget, for alot of insurance it also depends on "who" is reviewing your files a that time. So just because somone with your insurance got excepted "easily", doesn't mean you will have such an easy time also.

[AAA022414 13]

I'm in Florida, and I will keep you up to date. The office should be submitting for approval next week...... so we'll see:unsure:

did you call uhc? i had to call them before even going to see a doctor. my plan required that i see someone at a center of excellence so they needed to approve of a doctor before i went. in my case there isnt' a center of excellence in iowa so i had to go to minneapolis. i also got set up with a case worker so anytime i had a question or when the docs office submitted my paper work they submitted right to her and not just a generic uhc number. my case worker also set up my pysch eval which was their only requirement other than my bmi...did you need to do any of that?

[dyingbreed 1]

did you call uhc? i had to call them before even going to see a doctor. my plan required that i see someone at a center of excellence so they needed to approve of a doctor before i went. in my case there isnt' a center of excellence in iowa so i had to go to minneapolis. i also got set up with a case worker so anytime i had a question or when the docs office submitted my paper work they submitted right to her and not just a generic uhc number. my case worker also set up my pysch eval which was their only requirement other than my bmi...did you need to do any of that?

Do I have to go through center of excellence? ooooh I just pulled this up on myuhc web site....

Bariatric Resource Services (BRS) is a surgical weight loss solution for those individual(s) who qualify clinically for bariatric surgery. Specialized nurses provide support through all stages of the weight loss surgery process. Our program is dedicated to providing support both before and after surgery. Nurses help with decision support in preparation for surgery, information and education important in the selection of a bariatric surgery program, and post surgery and lifestyle management. Nurses can provide information on the nation's leading obesity surgery centers, known as Centers of Excellence. Access the Bariatric Resource Services Centers of Excellence programs at 1-888-936-7246 or visit www.urnweb.com.

All authorization information and enrollment for bariatric surgery must be initiated through United Resource Networks (U.R.N.). Covered participants seeking coverage for bariatric surgery should notify U.R.N. as soon as the possibility of a bariatric surgery procedure arises (and before the time a pre-surgical evaluation is performed) at a bariatric surgery center by calling U.R.N., at 1-888-936-7246 to enroll in the program.

[lindabear 0]

I have been approved for lap band by Kaiser in Freemont california---i was going to have gastric bypass loss 26 pounds and spent the next year quiting smoking and started menopause i am 60 and in five years due to disability have not been mobile-----i am very frustrated at having to loose the 10 percent which for me is 30 pounds and i can do 900 calories and loose very slowly- i really am not making excuses but am so mad that i have to do this -becuase of my disability i also have medicare and it is not part of myKaiser until 65 --i am going to try to find a doctor under medicare that i dont have to loose the 30 lbs---i am just so tired and depressed -i just want this tool - i am on 80 mg of lasix and flucuate from one day to the next 5 on 5 off- i was wondering if anyone new of a doctor in my area ii could talk to - i am even looking at financeing myself going into debt as this is that crucial for me- i have no real life and am very alone-some days the Water is so bad i cant even walk- they say it is menapuse and trust me i dont take in salt eat junk food - luckly cakes ice cream are not a desire for me- i

am really feeling hope less---well that is my story and hope some one can give some feed back--thanks Linda

[AAA022414 13]

Do I have to go through center of excellence? ooooh I just pulled this up on myuhc web site....

Bariatric Resource Services (BRS) is a surgical weight loss solution for those individual(s) who qualify clinically for bariatric surgery. Specialized nurses provide support through all stages of the weight loss surgery process. Our program is dedicated to providing support both before and after surgery. Nurses help with decision support in preparation for surgery, information and education important in the selection of a bariatric surgery program, and post surgery and lifestyle management. Nurses can provide information on the nation's leading obesity surgery centers, known as Centers of Excellence. Access the Bariatric Resource Services Centers of Excellence programs at 1-888-936-7246 or visit www.urnweb.com.

All authorization information and enrollment for bariatric surgery must be initiated through United Resource Networks (U.R.N.). Covered participants seeking coverage for bariatric surgery should notify U.R.N. as soon as the possibility of a bariatric surgery procedure arises (and before the time a pre-surgical evaluation is performed) at a bariatric surgery center by calling U.R.N., at 1-888-936-7246 to enroll in the program.

yeah you may want to call that number...that's what I had to do...

i hope you don't have to start the whole process over again...

what have you done so far?

[dyingbreed 1]

yeah you may want to call that number...that's what I had to do...

i hope you don't have to start the whole process over again...

what have you done so far?

Yup I called today and they said I have to go through the United Resource Networks...Grr....

So I called them and they said a nurse would call me back within a day or so.

Can you tell me a little about how the whole process went?

[three sixty six 1]

Because you're a LB candidate, the odds of you getting approved for an individual plan are very slim. You have a high BMI and are probably un-insurable under an individual plan.

Good luck!

[MacMadame 81]

I was turned down for individual health insurance by Blue Shield (or was it Blue Cross?) of CA in few years ago. So was my husband. They accepted our (normal-weighted) children with no problem though. Luckily he found a job right after that and we both got insurance that way.

That was one of the shocks that nudge me into considering WLS, in fact.

[AAA022414 13]

Yup I called today and they said I have to go through the United Resource Networks...Grr....

So I called them and they said a nurse would call me back within a day or so.

Can you tell me a little about how the whole process went?

The nurse called me back...we talked...she asked me what i weighed..how tall...what i've done in the past...really easy questions like that and she was really nice. all that they required was a certain bmi...which i think was 40 and up...but i'm not sure on that...a psych eval and for you to use a center of excellence. if you have to travel over 50 miles they reimburse you for your expenses. so she gave me a list of doctors and i picked the office that i knew where it was...like i said before i'm in des moines, iowa and need to travel for a center of excellence so i chose minneapolis because we have family there. so she said for me to call them and make an appt and she would contact united behavioral health and another nurse would call me to set up an appt for my pysch eval. i had an appt with a different doc here but had to cancel. you will probably run into more hurdles from your docs office than with the WF uhc plan. my first doctors appt was on jan 14th...i got in for my pysch eval on the 17th. i had to go back to the docs office maybe 2 more times...one was to meet with the surgeon and the other i can't remember what i did. i then had to go up for a preop class and my surgery was on feb 28th...so about 6 weeks in all. the united behavioral health person calls like every 4 weeks to check on you and to set "goals"...it's kinda annoying that's kind of a run down...i can answer more specifically if you want to know anything in detail...just let me know!