Humana Insurance (I work for Depart. of Education)....What's been your experience?

[mrucker 0]

I'm the one who started this thread, but on Friday, I got my approval letter from Humana! WHOO HOO! Cheryl, be sure that you have 6 months, plus your initial month (so 7 months total), and I do think that it has to be all on one form, so it may have to be the same doc. I'd contact the bariatric center in my 4th or 5th month and go for my all day appointment, that way you can get the ball rolling. I'm having my surgery at Georgetown Bariatrics (The lady who handles the state employee insurance there is FABULOUS and knows her stuff - her name is Jennifer). Anyway, I've got to go for cardiatric clearance this week, and and then for my 2nd all day appointment at the center, and schedule my surgery - I'm aiming for mid to late August. However, I think that I have decided on having Gastric Bypass instead of Lapband. After doing my food journal for my 1st appointment, I realized that maybe I was more of a "grazier" than I thought....Good luck to my fellow state employees....

[Busy 0]

Misty, good luck on your choices, we know our own habits so if you feel bypass is your route, as long as you get healthy. I agree, six months is the requirement and did end up doing 9 months before the process was over. After I had completed my 6 months I kept going just to give added info to Humana.

Cheryl, if this is what you want to do stay with it. I ended up getting legal aid to "encourage" Humana to approve. Research your appeal rights and meet your deadlines.

[cheryl1952 0]

mrucker & busy,

I am hoping I won't have to appeal because I have severe sleep apnea, high blood pressure, high cholestrol and borderline diabetic. I know the girl I have been speaking with at Central Baptist said that in August they would set me up for testing but I guess you don't see the surgeon until the insurance approves. At any rate I hope I can have this over by September. Good Luck to both of you. Do you know if the insurance pays for the fills? I sure hope Humana still does this when open enrollment comes in.

Cheryl

[Busy 0]

I had my first fill the end of May and am scheduled for another one in September. There was no charge for the fill in May. I guess I need to find out how long that will be n effect. Somewhere I heard they covered for 1 year and somewhere else I heard they covered for 2 years. I will find out and let you know. I would assume Humana would still cover, they have for the past few years it was just that since lapband was considered a "new procedure" they always denied. Now there is so much info supporting the benifits of weight loss surgery, insurance companies are approving it.

[nanna 0]

cheryl

iam a diabetic an have humana ins . does humana pay if you are a diabet i thought that was a plus to help you get your band.

[cheryl1952 0]

I would hope that it would be an access to getting the surgery. I don't know much about the insurance other than they look at all health issues.

[blueangelkc80 0]

I am also a state employee and have been going thru this since January. My doctors office sent the information to insurance on August 12 and I have yet to hear anything, and was beginning to wonder if anyone else who is a state employee had been able to get apporoved so reading this thread gives me hope :thumbdown:

[kysweetisgettinbanded 0]

I also work for KY school systems and Have humana PPO. I have met my deductable and out of pocket so it is a 80-20 co copay but i have secondary ins that will cover that. all i have to pay is the 500 dollar program fee that everyone who goes through gerogetown has to pay. I had to get a 6 consective month diet through my dr and have at leat a bmi of 40 or 2 weight related health problems. the center sets u up with everything else. (Psy eval, nutritionest etc.) Just call Georgetown Bariatric center and they will send you a packet with info with in 3 days. they also set u up an apointment with an insurence specialest that will research your plan ant tell you exactly how much you will pay out of pocket on the spot.

Hope this helps

I am waiting for my surgery date now. Should be with in the next 3 weeks I was told

Im so excited

Good luck

[blueangelkc80 0]

I finally got the approval on Sept 23rd and am scheduled for surgery on Oct 23 with Dr. Martin-Hawver at Christ Hospital in Cincinnati. For me it took about 9 months total to get it all approved and I think part of that is because I switched surgerons back in July.

[cheryl1952 0]

Hi,

I am having surgery on Wednesday. It didn't take no time for me to be approved by Humana. Probably because I have so many health problems and my doctor had everything I needed for them to send in. But, I made sure everything was correct. So, you have to communicate with the insurance girls to make sure you are getting everything you need. Good Luck to all of you in your approvals. Say a prayer for me and I will you. I will be having my surgery at Central Baptist Hospital. Dr. Weiss is my surgeon.

Cheryl