[starsthrumysoul]

Hi everyone,

I'm new here - I've been thinking about weight-loss surgery for a while, but finally called my insurance company today.

My question is this --> I talked to a woman at my insurance co. She said that for all weight loss surgery, if approved, I would only have to pay my inpatient deductible of $200 or outpatient deductible of $50 (depending on which I have to go for). I said "and that's all that I would have to pay to have this surgery?" and she confirmed.

I'm very suprised!! I'm still under my parents insurance (I'm only 23) and so don't know much about my plan, but figured I would at least be paying 50% or something! I have Preferred Care Opportunity. Does anyone else have Preferred Care? I want to know as much as you want to tell me about your experience - how hard it was to get authorization, the costs to you/coverage, etc.

Thanks everyone!!!!!

[MsVickie]

Honey the one thing I would tell you to do is call them back. Ask them this question.

Does my policy over Weight Loss Surgery.

If so what is the criteria I have to meet to get approved.

If they cover the surgery 90% of the battle is won. Is the Preferred Care a part of Blue Cross Blue Shield? You can tell that buy the claims address on the back of your card.

I would say you have a great insurance policy. You will be paying the bigger of the two because its not outpatient. Im still preop but know alot about how insurance comapanies work. If they will pay for it, and you meet there criteria there is no reason you cant do it.

I will say please reaseach this surgery fully before making the decision and research your selected surgeon fully. Remember you dont always have to go to the one you first see. I didnt. Good luck

[fr1endly2]

ONLY costs i incurred were copays for dr visits...wasnt too much at all
and was worth every 20 dollars i gave each specialist for my pre op
clearance for the gastric bypass surgery.

WELCOME to the boards and i look forward to getting to know you thru your posts!
BEING young i am sure you wont have to have nearly the pre op clearances as someone my age but i had to have an upper endoscope, gall bladder sonogram, see a pulmonary specialist, cardiologist, have a pscy evaluation,
see a nutritionist and have blood work up for my clearance for the surgery.
SOME of these appointments had the co pays others didnt.

hugs

[A new me]

I have Preffered Care. Im not sure if there is a secondary name to it like yours but I do have Preffered Care. I had hear horror stories about them not covering surgiers and etc.......So I had been going thru all the necessary steps and appoitments for well almost 9 months. I didnt know until the end if they were gonna cover it or not. I pretty much had it in my head that they wouldnt cover. Even my surgeons office had said. oh they are not good about coverage. Then about 3 days after my final appoitment boom they called and said I was approved. So you never know.

I would call back like someone said. Just try to get more information and go from there.
Best of luck.

[Kenyar]

i would call back and ask the specifics. I dont have that insurance. I have blue cross blue shield and everything was covered. I had no deductible and no coays for any visits related to this surgery. which is GREAT. i am very lucky and grateful.

But yes please do double check and ask the specific questions msvickie suggests. see what info that gets you. good luck on your journey. and WELCOME to the boards!

[DocSanae]

Welcome to the board, thank you for joining us.
((((((HUGS)))))) May your journey go well.

I second MsVickie's opinion. As well as checking back with insurance, please do a lot of research and search, too,. Not just the good, but the bad as well. Both about the surgery and the surgeon. When you meet your surgeon, ask him as many Qs as you can, including his own statistics with his patients. You need to be informed FULLY of what this surgery entails, what changes in life you must make to succeed. Always keep in mind, this surgery is a tool and you have to work hard to use the tool and make it work. It is not a magic wand that will do all the work for you.

Good luck in your search and research.

[starsthrumysoul]

Wow, thanks so much everyone for the information and encouragement!!

I haven't yet decided which route I want to go, but thinking I'm leaning more toward the lapband surgery than gastric bypass, for many reasons. Yes, I am young, which I'm not sure if will work with me or against me. I've been significantly overweight all my life. When I turned 18, I had to have my gall bladder removed (stones), and then last year I had a very sore back and through an MRI discovered that I have arthritis moving up my discs (yes, 23 now). My father is 61 and has been through everything I have (overweight, gallstones, arthritis really bad) and then some (high blood pressure, cholesterol). I don't want to go down the same road he did. During college I had a bout with bulimia and dropped 70 lbs. very very fast (which I'm not sure if that might work against me). However, after I lost that weight, even though I was STILL overweight (180 lbs.), I realized that I felt SOOOO comfortable in my own skin. I was breathing better, and wasn't constantly thinking about whether my belly was showing, or if someone was staring at my thighs. That in of itself is a giant weight lifted (no pun intended!). My ultimate goal is to reach ~170 lbs, which I think would be good for my frame.

So that's my story.. I've tried weight loss plans before, namely weight-watchers, and a general low-cal diet. I'm currently a member at an aerobics club, but have had memberships at an additional 4 places in the last few years. I think my biggest problem is that I overeat. I always tell people that I don't have a hard time eating right (because I love healthy foods), but I do have a hard time not eating bad (because I love unhealthy foods too!). I need self-discipline, and I don't know where to look to get it. My hope is that bringing some of the weight off will motivate me to look for it.

Anyway, thanks for all of the advice. When I spoke with my insurance rep yesterday, she talked to me about the lengthy approval process and what is needed. She said that I would need receipts for all of my weight-loss attempts (gyms, weight watchers memberships), which I don't have. But, it sounded to me like the surgery would be covered. I think I was too suprised to believe her.

Thanks again everyone, and I look forward to getting to know you!