Optima Health will they cover it? - ThinnerTimes - Gastric Bypass Forum, Lap Band Forum, and Vertical Sleeve Gastrectomy Forum

Marina · 01-26-2009, 08:11 PM

OK my optima Health care doesnt cover the Gastric Bypass however they said my doctor can write a request letter which I just got Friday and I sent it off today. Im excited but scared of them still saying no. Has anyone had optima cover their gastric bypass? If so did u have to jump through hoops?

Marina · 01-27-2009, 08:39 AM

That's Scary

no one has had Gastric bypass while being insured by Optima health care. Well I will keep everyone updated on how they do things. I dont think insurance companies have the right to deny u if u have medical issues. Now if u are over weight because u eat twinkies and pies all day well that is a different sory I guess :-)

Marina · 01-28-2009, 09:12 PM

Well I got a message from my insurance company. I have to call them back tomorrow but she said the letter I mailed in from my doctor cant come from me it has to come from my primary care doctor or my bariatric doctor whoo hoo so I do have a chance. She didnt say no we are not covering it no matter who sends it in! Im excited! Wish me luck Im calling her tomorrow morning.

LyndasRoom · 01-28-2009, 09:51 PM

Good luck Marina...most time they say it's not covered, unless it's a case of 'medical necessity'..that's determined by your BMI. Obviously your doctor believes you're a candidate. Many times getting approved is simply a matter of jumping through all the hoops that the insurance company puts before you...hopefully you'll know more soon!

Marina · 01-29-2009, 06:16 AM

Yes I hope everything goes well...................im excited

Marina · 03-14-2009, 08:04 AM

Well I went to my gastric bypass surgeon and we are going to wait until I have my sleep study on the 22nd of march before we send in my information. That way I have another thing on my list ;-) anyways how does an appeal work if they deny? Do u appeal it or do u get a lawyer?