Hello everyone!! I was wanting to get some input on how hard it is to have insurance approve the surgery. Thanks!
Insurance is a major concern for those of us who have been lucky enough to have our surgery covered by insurance. By chosing a good bariatric team, they will be your best ally and advocate to get your surgery covered. I would suggest you do some research on your own with your insurance company. Take a look at the policy or give them a call. Better to know up front than later. Remember also that it is not just your insurance provider that determines your benefits, but the plan that your carrier follows is set up with your employer and the carrier. So all Blue Cross Blue Shield patients, my not have the same requirements.
I have Aetna and had a very easy time. My bariatric team had a lot to do with that. My requirements to qualify were basically a bmi of 40 or above or 35 with 2 comodalities such as high blood pressure, high cholesterol, diabeties, etc.
Good luck.
New federal laws prohibit "Pre existing condition" clauses. I THINK that has started...it may start in 2014...hopefully not!
The big thing to remember with insurance, especially if you have it through your employer, is that there can be minor tweaks even with the same product from the same company. This is more prevalent with employer provided insurance as employers pick and choose options to keep costs affordable. I am thinking the pre-existing conditions takes affect on 1-1-2014. Lots of changes will roll out then. I am a business analyst at a health insurance company and have learned lots the past 14 months I have been employed there. Your best bet is to directly call your insurance and find out the requirements. It is important to find out if they have a 6 month dr supervised diet piece of the process and exactly what that entails as I have heard a wide range of descriptions, even with my own insurance company.
I had BCBS of GA with my previous employer and they did not cover it but my employer also bought whatever the bare minimum they had to. Call the 800 number and ask it will probably take them a week or two to call back with an answer. There should also be a complete booklet of what is covered online that you can read through as well. I think it's called a certificate book if I remember correctly.
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