New member here
Hello all! I have an appointment with my family
dr. Dec.3. I have to get a referral to see a gastro
doc. I am so afraid that my insurance, Humana HMO is
going to tell me no! Anyone with any experience with
Humana? I am 5-6 and weigh 330 lbs. Right now I don’t
have any serious medical problems. Blood pressure is
great. My cholesterol is high, I’m sure. I haven’t had
it checked in over a year. I am not diabetic.
Basically I am pretty healthy, that’s why I fear the
insurance may turn me down. I would appreciate any feed
back to the insurance questions. Also, how long do you
have to be off work? I have read a ton of information
on the web about this surgery and it seems to be
more successfully than not. I haven’t read all the
messages here, but, the few I did read sound positive. I
am going to keep me fingers crossed that Humana will
approve this!! Does anyone know of any good surgeons in
the KC area?
August 6th, 2003 at 3:38 am
Hi and welcome to the group. You will learn alot
here. I too thought that I was healthy, not realizing
that alot of the things I experienced are considered
co-morbidities. My suggestion for getting insurance approval
would be to have things documented. painful joints, leg
cramps/spasms, incontinence, possibly even gall stones (even if
you think your not having trouble) sleep apnea. If
these things are already in your medical file it will
help. Some insurance companies go by BMI alone and some
are real picky. Good luck & hang in there. Mary
August 6th, 2003 at 2:20 pm
Hi and welcome!<br><br>All insurance companies
are different and unless they specify they cover the
procedure 100% - they can differ from case to case. The
best thing to do is go to your appointment and give
them a thorough history. Much like you, I did not have
any "serious" medical problems besides my weight -
but as I have learned and now am seeing first hand -
the weight alone is a serious medical problem. I am
going on 7 weeks post op and am down 42lbs. and feel
110% better!!! I also have a HMO for insurance and
they were surprisingly helpful - I have not read very
many postings where the insurance company actually
denied the procedure - more of them giving people the
run-around or taking months to approve. Alot will depend on
your surgeon and the letter they write to request the
procedure. Ask about this when you go for your appointment.
Also - there are alot of websites out there from
post-ops who have given examples of their insurance
letters - Try the website obesityhelp.com too - alot of
really good info there. Go in as educated as you can and
let your surgeon you mean business!!!!<br><br>Good
Luck and I hope to read soon that you are
approved!!!<br><br>Gera Ashton<br>VBG 7 wks postop