Re: Insurance/Approval Question

[Guest guest]

,

Welcome to the group.....I dont have that insurance, but good luck with

everything.....

Mike T

Insurance/Approval Question

> Good Morning! Its me, a friendly new lurker from Long Beach, CA!

>

> My new insurace policy, Pacific Care of CA, becomes effective on

> January 1st. This new policy will cover WLS, and I already have an

> appointment on January 2 to meet with my doctor who is aleady super-

> supportive of my decision and has my referral for surgery already

> prepared.

>

> I'm really excited to begin this journey.

>

> My question is: Has anyone with this same insurer been RECENTLY

> required to participate in a 6-month educational " coaching " call prior

> to being approved for surgery? I already have 6 months of diet &

> exercise documented. Was the 6-month class waived or reduced for any

> reason?

>

> I'm trying to get mentally prepared for what the approval process might

> involve. Any input you can offer is greatly appreciated.

>

>

>

> We are a very active support group.

> If the email becomes overwhelming,

> please change your setting to NO EMAIL!

> Please contact Group Creator

> Robyn@...

>

>

>

[Guest guest]

Can't help you out w/ the insurance; but just wanted to say welcome to

the group! :-)

W

380/255/160

wrote:

> Good Morning! Its me, a friendly new lurker from Long Beach, CA!

>

> My new insurace policy, Pacific Care of CA, becomes effective on

> January 1st. This new policy will cover WLS, and I already have an

> appointment on January 2 to meet with my doctor who is aleady super-

> supportive of my decision and has my referral for surgery already

> prepared.

>

> I'm really excited to begin this journey.

>

> My question is: Has anyone with this same insurer been RECENTLY

> required to participate in a 6-month educational " coaching " call prior

> to being approved for surgery? I already have 6 months of diet &

> exercise documented. Was the 6-month class waived or reduced for any

> reason?

>

> I'm trying to get mentally prepared for what the approval process might

> involve. Any input you can offer is greatly appreciated.

>

[Guest guest]

I have great insurance, but it did require4 a 6 month supervised " diet

and exercise with monthly check ins with the doctor " before being

allowed to submit to be referred to the surgeon.

But also, I have only recently in the last 8 months gained all my

weight (quitting smoking etc, and at 51 and with my family history) do

not intend to wait that long to get this surgery. My insurance

required that first I be at the BMI of 35 or 40, depnding how they

read what else was wrong with me, for one year, before even beginning

the 6 month period, then I was so scared I'd had to go back and forth

with them another 6 months of fighting and appealing to get approval.

I'm not in the mood to waste this kind of time. So I'm paying $12,500

to Dr Alberto Aceves, in Mexico and getting my surgery there on 10 Jan.

I belong to one of his weight loss group and I'm so impressed with

what all they say, these are mostly lap band, but a few gastric by

passers. I was also given a list of past gastric by passers who had

surgery with him. and they couldn't talk enough. So I feel I'm in

safe hands. I don't really care for the traveling part but for me

like you, you want the weight off, and don't won't further medical

problems.

Good luck and I hope it runs a smooth and steady course for you

[Guest guest]

Thanks for the welcome !

[Guest guest]

Welcome !

Kim in PA

RNY 6/23/06

298/205/135

>

> Good Morning! Its me, a friendly new lurker from Long Beach, CA!

>

> My new insurace policy, Pacific Care of CA, becomes effective on

> January 1st. This new policy will cover WLS, and I already have an

> appointment on January 2 to meet with my doctor who is aleady

super-

> supportive of my decision and has my referral for surgery already

> prepared.

>

> I'm really excited to begin this journey.

>

> My question is: Has anyone with this same insurer been RECENTLY

> required to participate in a 6-month educational " coaching " call

prior

> to being approved for surgery? I already have 6 months of diet &

> exercise documented. Was the 6-month class waived or reduced for

any

> reason?

>

> I'm trying to get mentally prepared for what the approval process

might

> involve. Any input you can offer is greatly appreciated.

>

[Guest guest]

, I did not have to go through that. I only had the 6 mo. diet.

cappucino_diva@...> wrote: Good Morning! Its me, a

friendly new lurker from Long Beach, CA!

My new insurace policy, Pacific Care of CA, becomes effective on

January 1st. This new policy will cover WLS, and I already have an

appointment on January 2 to meet with my doctor who is aleady super-

supportive of my decision and has my referral for surgery already

prepared.

I'm really excited to begin this journey.

My question is: Has anyone with this same insurer been RECENTLY

required to participate in a 6-month educational " coaching " call prior

to being approved for surgery? I already have 6 months of diet &

exercise documented. Was the 6-month class waived or reduced for any

reason?

I'm trying to get mentally prepared for what the approval process might

involve. Any input you can offer is greatly appreciated.

__________________________________________________