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Thread: Kaiser covers the sleeve?

Started 1 month ago by Mandyplus2
At my seminar today, the surgeon said that Kaiser covers VSG. So, for those with Kaiser, I found this link stating their criteria for referral: http://www.permanente.net/homepage/kaiser/pdf/38 105.pdf But I need to know how many years of documentation they need at a particular BMI. For instance, Aetna (my insurer) wants two years of documented proof at your qualifying BMI. Also...
Site: Weight Loss Surgery Forum - Obesity Help Main  Weight Loss Surgery Forum - Obesity Help Main - site profile
Forum: Vertical Sleeve Gastrectomy Forum (VSG)  Vertical Sleeve Gastrectomy Forum (VSG) - forum profile
Total authors: 7 authors
Total thread posts: 14 posts
Thread activity: no new posts during last week
Domain info for: obesityhelp.com

Other posts in this thread:

thereason79 replied 1 month ago
Hi Mandy, Yes, Kaiser does cover the sleeve. That was my reason to switch my insurance provider when I had wasted almost two years trying to get qualified with HealthNet, as it seems to be the case with Aetha for you. In the end, they decided I did not have a medical reason for VSG, which I later came to find out was not the truth (asthma). The process at Kaiser is lengthy, but the ...

Mandyplus2 replied 1 month ago
Thank you for the info! You said it's a lengthy process...can you tell me about how long the process took?

phred replied 1 month ago
( Here, in Colorado, it took a year from starting the weight loss journey until I got my sleeve.  I attended a 7 week "Weight Connections" class. Then had once a month sessions with the weight loss counselor for about 5 months, then took a 12 week "Surgical Connections" class. About a month later \(after a psych eval\), I got my sleeve. This was in October of '08.  Since then I have ...

Laura R. replied 1 month ago
( I didn't have to demonstrate any history at a certain BMI or above. Just met the minimums \(and then some\). I got the sleeve with Kaiser although it wasn't officially offered as an option. All the literature and pre-surgeon appointments I had discussed only band and RNY. It was my surgeon who looked at my medical history \(I've had three prior abdominal area surgeries\) and suggested ...

SmileyGael replied 1 month ago
( Hi-jack....Lookie there!  Mr.Fred has a smilin face!  Good to see you! ,)

SmileyGael replied 1 month ago
( Hey Laura, I just had my psych eval friday in Fremont.  Dr Hahn has already emailed me saying I can get a VSG...So now I wait for a date... Ok Mandy, here is my experience...Also you can read my profile to see how long, and why its taken 3yrs... Anyhoo, we switched to Kaiser cause it was the cheapest ins. offered.  I asked my PCP for a referral to the Bariactric program, and she ...

Mandyplus2 replied 1 month ago
That is so funny because I was just telling my mom today that I HATED having Kaiser many years ago. It was the worst! I felt so controlled, like I had ZERO choices of my own (treatment, doctors, etc). They would just tell me how everything was going to be, who to go see, what they would do, etc. I believe my mom has Kaiser now, or had it until she recently retired, and she loved it. I am ...

Jen4404 replied 1 month ago
( In Northern California the whole process takes a year- from the day you first ask for a referral to the day you have surgery. Getting approved is fairly easy if you meet the BMI requirements. You don't have to prove how long you have been at the weight and you don't need to document previous weight loss attempts. Kaiser is a low stress way to go, you don't need to deal with appeals and a ...

Laura R. replied 1 month ago
( While I was frustrated and impatient during the first months of the process, I am now SO grateful for the Kaiser hoops, I can't offer enough praise. They do their darndest to inform you and to ease you into the wls lifestyle. I read about folks who had little pre-op prep, and I think, "Wow, the transition to the post-op life must be overwhelming for you." I'd already spent months weaning...

thereason79 replied 1 month ago
I have to second what everyone else said here about Kaiser. They were definitely not my first choice, I was very happy with HealthNet, but they denied VGS, and after my appeal, I was denied again. I wasted about two years with them, and finally went back to Kaiser. A a former member, I've been very impressed with the changes they have made for a HMO. I had my own private room, and the medical ...

 

Top contributing authors

Name
Posts
Mandyplus2
5
user's latest post:
Kaiser covers the sleeve?
Published (2009-11-15 08:36:00)
I am a SAHM so it's through my husband's employer.
thereason79
2
user's latest post:
Kaiser covers the sleeve?
Published (2009-11-14 20:20:00)
I have to second what everyone else said here about Kaiser. They were definitely not my first choice, I was very happy with HealthNet, but they denied VGS, and after my appeal, I was denied again. I wasted about two years with them, and finally went back to Kaiser. A a former member, I've been very impressed with the changes they have made for a HMO. I had my own private room, and the medical staff were just great during my recovery. The...
Laura R.
2
user's latest post:
Kaiser covers the sleeve?
Published (2009-11-14 20:16:00)
( While I was frustrated and impatient during the first months of the process, I am now SO grateful for the Kaiser hoops, I can't offer enough praise. They do their darndest to inform you and to ease you into the wls lifestyle. I read about folks who had little pre-op prep, and I think, "Wow, the transition to the post-op life must be overwhelming for you." I'd already spent months weaning myself off my great obsession --...
SmileyGael
2
user's latest post:
Kaiser covers the sleeve?
Published (2009-11-14 18:22:00)
( Hey Laura, I just had my psych eval friday in Fremont.  Dr Hahn has already emailed me saying I can get a VSG...So now I wait for a date... Ok Mandy, here is my experience...Also you can read my profile to see how long, and why its taken 3yrs... Anyhoo, we switched to Kaiser cause it was the cheapest ins. offered.  I asked my PCP for a referral to the Bariactric program, and she referred me that day. I got an appt. for the orientation...
phred
1
user's latest post:
Kaiser covers the sleeve?
Published (2009-11-14 17:45:00)
( Here, in Colorado, it took a year from starting the weight loss journey until I got my sleeve.  I attended a 7 week "Weight Connections" class. Then had once a month sessions with the weight loss counselor for about 5 months, then took a 12 week "Surgical Connections" class. About a month later \(after a psych eval\), I got my sleeve. This was in October of '08.  Since then I have attended once a month sessions...
Jen4404
1
user's latest post:
Kaiser covers the sleeve?
Published (2009-11-14 19:22:00)
( In Northern California the whole process takes a year- from the day you first ask for a referral to the day you have surgery. Getting approved is fairly easy if you meet the BMI requirements. You don't have to prove how long you have been at the weight and you don't need to document previous weight loss attempts. Kaiser is a low stress way to go, you don't need to deal with appeals and a lot of requirements, you just need to...
jillybean720
1
user's latest post:
Kaiser covers the sleeve?
Published (2009-11-15 08:18:00)
( Is your insurance through your employer or through your husband's employer? Is there a way you can get Kaiser for yourself through your employer and keep your family on another insurance through his employer? Come January, my husband and I will be on different insurances through our own employers - much more affordable in our case. ,)

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