Getting insurance approval. How hard?

brynn3
on 7/20/13 12:06 pm - MI
VSG on 10/16/13
I guess I've been living in a fantasy world thinking insurance approves the first time. If not, then definitely the second time. Starting to hear that's not the case. I'm 4'11" and last weigh in st 208. No health issues except arthritis in knees and ankles. Guess I'm starting to stress a little about it now.
abbeycat43
on 7/20/13 12:17 pm - MO
VSG on 06/12/13

Depends on what insurance you have, what their requirements are, and if you meet them...I was approved first time, in about 2 weeks, I met all their guidelines and have Aetna. I'm 5'3", 263 lbs, BMI: 46 and no health issues except body aches and pains from being overweight.  Your insurance should be able to tell you what their requirements are and a lot of them have this information online.

brynn3
on 7/20/13 12:31 pm - MI
VSG on 10/16/13
Thanks, for replying. I'm following everything my insurance requires and my primary doctor has ordered a few extra tests. I guess I'll cross my fingers and toes.
DonnaMaria
on 7/20/13 12:39 pm
I have been denied by Oxford. I am a revision. I was denied because I never went to my surgeon for a check up in 2012. I also have a BMI of 34.

 

brynn3
on 7/20/13 1:04 pm - MI
VSG on 10/16/13
Sorry to hear that Donnamarie. My bmi is 42, so I'm pretty big because of my height. I used to love being short but it has way too many disadvantages.
cappy11448
on 7/20/13 12:57 pm

Getting my insurance to cover my surgery was no problem, but I was a heavy-weight.  I had to do a 90 day pre-surgery diet, and as soon as that was done, the hospital submitted the paperwork, and the approval came in less than a week.  I had surgery 3 1/2 months after my initial appointment.  If your BMI is high enough that you meet the guidelines hopefully it will go smoothly.

Best of luck on your weight-loss journey.

Carol

    

Surgery May 1, 2013. Starting Weight 385,  Surgery Weight 333,  Current Weight 160.  At GOAL!

Weight loss Pre-op 1-20 2-17 3-15 Post-op 1-20 2-18 3-15 4-14 5-16 6-11 7-12  8-8

                  9-11 10-7 11-7 12-7 13-8 14-6 15-3 16-7 17-3  18-3

     

brynn3
on 7/20/13 1:01 pm - MI
VSG on 10/16/13
Carol thanks for getting back to me. Do you have Cigna? I do and they require 3 months also. I just did my 2 nutrition class/weigh Thursday.
Christine O.
on 7/20/13 3:53 pm - OR
VSG on 07/05/13

Once I'd lost the 5% and seen the NUT and Psych as required y my insurance, I was approved in 24 hours, but my starting BMI was 52. The guidelines in my insurance handbook clearly say a BMI of 50+ is approved with no comorbidities. For BMI of 40-49 they required one serious comorbidity and for 35-39 they require diabetes plus another comorbidity. Every insurance is different though. 


HW 309 ~ SW 267 ~  GW 149 ~ Early pre-op: -28; 1 wk pre-diet: -14; M1: -21, M2: -15; M3: -16

lowbrass03
on 7/20/13 6:29 pm - houston, TX
VSG on 05/17/12
I have Cigna and they really didn't ask for much. But then again the hospital I work for has a special clause with Cigna that although makes it easy to get approved, restricts who we can go to for our surgery.
    
            
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