hello

[shortnsweetnms]

Hello all my name is Nancy and I am in the process of doing the steps to have the gastric bypass done. I attended the seminar on June 12th to find out the process for the surgery and what I needed to do. Still have not heard from the insurance company yet to see if the surgery will be approved, I have United Healthcare Choice Plus. My family dr suggest that I have this surgery to get the fluid on my feet and ankles under control as well as the pain to my back and hips.
I would like to know if the insurance is gonna pay because they want to charge me for the physocialogial part of the process. only $200 , but that is a lot of money when you are on a fixed income. I am nervous about the surgery and want to have it done for my health because I am tired of not feeling good. Any advice would be appericated.

 

[TwoMas]

Hi Shortnsweetnms, Welcome. Insurance companies have different steps we must follow before we get approval and get into surgery. I don't know about everyone else but the phsychological exam is all part of the prosses as well as other tyests we must have, liver, ekg, bloodwork and some even have sleep studies, epecially if they have a history of sleep apnea. The 200.00 is not part of the co-pay, I think I had to pay 500.00 out of pocket maybe a little more when all was said and done. We have all felt like you do and we know the fear and nervousness as well as the anxiety of the thought of having surgery, we also know the feeling of trying everything else and nothing working and even if it did work it was so short term and the weight came back quicker than when we lost it. Remember you are doing this for your health and I am sure you took a lot of time before deciding on this and I am sure that your doctor knows to or he wouldn't have suggested it. So hang in there and make sure that you get all the upfront cost out in the open so you can budget for them because money is always a part of equation because all the other bill have to get paid too. Let us know how you are doing, there is a lot of support here to help you through this journey, if you so wish. Tom

 

[Javajoy]

Hi Nancy,

My center was so open and upfront about costs above and beyond what insurance or Medicare would pay. My program fee which included all the booklets, Psychological exam, nutrition information, and first consultation with the surgeon was almost $600. Insurance will not pay these fees according to the center where I went. In fact, they sent me an email the very next day after the seminar regarding what my out of pocket expenses would be. Good luck on your journey. Medicare requires a six month weight loss trial and I know other insurance programs have different requirements but your center should be able to inform you of what the requirements will be and if you have any other copays. Joy

 

[Pat99]

Nancy-Medicare requirements vary from state to state as do all meidcal insurance's. Although Medicare required me to have a six month "weight loss program" with a medical doctor all I needed was documentation from my PCP that weight loss was discussed during our visits over a six month time period. I didn't have to start from scratch so the documentation was readily available from the office visit notes. I was one of the lucky ones and received insurance approval with 24 hours after all of the required documentation was sent in. And I didn't have to do anything except show up for all of the testing and blood work. The insurance coordinator from the surgeon's office did all the leg work getting all of the documentation together. This took all a lot of the stress off of me

You're about to embark on a journey to a healthier new you. You may get caught up in the games some insurance companies play but don't get discouraged. It will all be worth it in the end. Make sure to come back to the forum to let us know how things are going and how you are doing.