Question:
Can you get approved for wls even if you've never used the insurance company.
I have had my ins for about 10 mths, but I have never used it because I have been using my husbands benefits. Will the ins co. deny me because I do not have a history of claming any dr. visits or prescriptions with them? — Princess J. (posted on September 26, 2001)
September 26, 2001
Maybe... although I don't think so. When talking with my insurance co. on
the phone, they told me I had been approved, due to the fact that I had
hundreds of claims for drugs, doctor visits, tests, xrays etc. all for
weight related symptoms, so in the long run it would actually be an
investment for them to approve me, as it would defintely reduce those
claims... but that was just me... call and ask, also explain that you use
your husbands, hence no claims. Ask to talk to the pre-determination /
certification / approval department, as they usually would handle your file
when it got there, and would probably be most privy to that information.
Good Luck!
— [Anonymous]
September 26, 2001
Hi there~
I had my insurance for over a year and never used it except for dental
once. I had no doctors appts until I started going to my WLS doctor to
start the process. I got approved with the first try. I never had so much
as a check up with them! I have Blue Cross PPO. Let us know how it goes
and good luck to you!
— Jen S.
September 26, 2001
Hi - I had changed my insurance provider in January '01. I had no claims
made until I went to my new PCP to request a consult for bariatric surgery.
The only thing I brought to my pcp was a detailed weight loss/diet history.
I say my pcp in May, 1st surgical consult in May - insurance approval and
surgery in July. I have Empire Blue Cross / HMO.
Good Luck!
— Jean K.
September 26, 2001
I had AETNA PPO for only two months before I used it for my gastric bypass.
I had never used it before and cancelled it a year after my surgery. I
don't think you'll have any problems at all. (smile)
— Mavis C.
September 26, 2001
I signed up for Aetna in June, it started in July. I saw my PCP on the 5th,
got a referrel, saw the doc a week later and got a cancellation and had
surgery on July 23rd. It is very possible. The biggest key is selecting a
PCP carefully who will not hassle you and will give an automatic referral.
I actually called the office and asked the nurse who was the most
sympathetic doctor and picked him. That way you can skip all of the repeat
visits and attempts to get a referral. But it is definitely possible!
— Courtney W.
September 26, 2001
I was on my husbands plan (Oxford Freedom Plan) as of March 1, 2001. I
called my surgeons office for a consult in April for May 15th and I was
approved by June 4th, had surgery on July 20th.
— Dawn H.
September 27, 2001
probably a mute point.. check for possible pre-existing.. which actually
probably won't apply if you have been getting services for a minimum of 6
months under the other plan and check to make sure it's a benefit to have
wls.
— Dawn R.
September 27, 2001
I was very lucky with my insurance company. I got coverage
on jan 1, 2001. My PCP sent a referral over to the surgeon
for my appt. on Jan.15,2001 and I was approved on Feb. 16th.
BTW, I previous had Blue Choice and my surgeon's office told
me not to even bother with them, but to wait until my new
insurance (United Health Care Select HMO) went in to effect.
They have been wonderful to me and picked up everything.
— Debra L.
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