Elmer L. Valin M.D. -

Insurers

There are many ways patients cover the cost of their surgery. Some have insurance benefits that cover weight loss surgery, while others pay out of pocket. There may also be other resources available to you such as government or federal programs or agencies that may be able to assist you. Read some our patient's comments about how they obtained their surgery. PLEASE NOTE: These are comments posted by the public. We do not endorse or recommend any of the companies or agencies below.

Aanthem Bllue Cross/Blue Shield - State Prefered (CT) - 01/24/03
I had no direct contact with the insurance company at all other than the letter they sent to me stating that the proceedure was approved. Dr. Valin's office sent in the paperwork from all my testing along with a letter from my Primary Care Physician and a litle over a week later I got the letter of appproval. (Rebecca P.)

ABlue Cross Blue Shield (CT) - 11/03/03
my surgeons office dealt with the insurance company - i had all my ducks in a row as far as past diet history and a letter from my PCP - not sure if this expedited things or not (liz s.)

Aetna - PPO (CT) - 06/12/02
(Amy M.)

Aetna (CT) - 02/24/2006
Aetna requires 6 months physician supervised diet or 3 month surgical prep (which includes visits with dietician and psychologist). I chose the latter. Once submitted, it seemed I could not get a straight answer from anyone at Aetna. I finally got my human resources department involved and had approval the next afternoon...Overall, the process was not terrible. (Laura G.)

Aetna - PPO (NC) - Aug 2005
They SUCKED!!! I was denied out of hand and never really given a good reason why. I appealed to both Aetna and the State of Connecticut, who in the end could do nothing to compel Aetna to cover the procedure. The whole process dragged out over nearly two years until the company I worked for, at the time, merged with another company who has United Healthcare as their provider. United Healthcare covered the Open RNY and I was able to have the surgery the same month my new insurance became active! (Joe M.)

Aetna US Healthcare - Managed Choice POS (CT) - 09/06/00
Doctors office dealt directly with insurer. It was a miracle - there were no problems!! (Bettina V.)

AETNA US HEALTHCARE OPEN CHOICE PPO - OPEN CHOICE (FL) - 07/27/01
I had no problems with this insurance. The surgery is covered, if medically neccessary and I haven't received one bill. I was approved very quickly, once we had the papers faxed to them. (Lee (Liza) B.)

anthem - state bluecare (CT) - 6/28/01
Once the Doctors office contacted them it only took two days (sandra p.)

Anthem - Poe (CT) - 04/21/03
(Megan S.)

Anthem - PPO (CT) - 4/28/2004
Anthem was very prompt with their authorization. I had no issues. (Tari X.)

Anthem - Century Preferred (CT) - 12/26/04
The whole process was very easy and they were respectful to me during my one and only phone call to them to check on my co-pay (had it by choice at an out of network hospital). Dr. Valin's staff really handled most of the dealings with the insurance company. (Cristina S.)

Anthem - State Bluecare POE (CT) - 10/11/05
My doctor’s office dealt with the insurance company for me, so it wasn't really bad for me. I do think the insurance company has a policy to reject all the first time, and then when you resubmit they take a more serious look at your illnesses. (Georgia S.)

Anthem - ppo (CT) - 7/10/05
(Kelli B.)

Anthem (CT) - 10/12/05
(Deborah T.)

Anthem (CT) - 04/29/06
My doctor's office delt with everything. They got everything ready, submitted it to the insurance company, and I was approved in less than a week. I didn't have to persist them, and don't really know much about directly dealing with them (I have two policies through them-both mother's and father's). (Kelsey R.)

Anthem BC BS - PPO (CT) - 09/02/04
My surgeon's office got the approval once all the necessary info was in order. BCBS approved me with the first application. I was not worried, I met all of the requirements. (Donna T.)

anthem bc/bs - Anthem (CT) - 03/29/02
it took them less than a week-2 days! But I did do alot of research first..and I did have my PCP write a letter stating I had 12 mo consecutive Medical supervised diet. I heard that's what they wanted..so I wanted to cover all of my bases. (Raven ..)

anthem bc/bs - hmo (CT) - 04/08/06
i had no problems so far with the insurance company, the dr. office took care of everything. (tinna f.)

Anthem Blue Care - PPO (CT) - 05/26/01
They were very prompt in giving me an answer. They required a great deal of information, so be organized and keep copies of everything! (Lori K.)

Anthem Blue Cross - Century Preferred (CT) - 4/24/01
(Kim E.)

ANTHEM BLUE CROSS (CT) - 03/09/01
KEEP TRACK OF ANY DIETS YOU HAVE BEEN ON BECAUSE THEY WILL WANT A LIST OF DIETS YOU HAVE TRIED..I HAD A LIST FOR THE PAT 20 YEARS SO THAT PROBALLY HELPED..PLUS MY DOCTOR HAD A LOT OF DIETS LISTED THAT I HAD TRIED THROUGH HIM.. THE DOCTORS OFFICE APPLIED FOR APPROVAL ON WEDNESDAY I HAD APPROVAL ON MONDAY AT 4:00 PM..HAD SURGERY NEXT MORNING...CUTTING IT A LITTLE TO CLOSE.. (SUSAN R.)

Anthem Blue Cross - Century Preferred (CT) - 05/26/01
Anthem has certain compliance that you must have to be approved. I suggest you make sure you know what they are ahead of time. YOu must be morbid obese for at least 5 years and you MUST show a diet history for 12consecutive months. I made copies of my weight watchers books and that is what changed their mind. I also wrote to my political city representatives and complained. They definitely respond to persistence and they seemed very arbitrary in their decisions allthough they say they do the same for all. (debbie K.)

Anthem Blue Cross - PPO (CT) - 06/30/04
(Ann M.)

Anthem Blue Cross - State Bluecare POE (CT) - 02/10/05
I did not have contact with the insurance company. Dr. Valin's office took care of the entire process. Approval was given in 2 days. (Ray M.)

Anthem Blue Cross (CT) - 11/10/05
The office submitted all the paperwork and I got an approval letter about two weeks later. (Scott W.)

Anthem Blue Cross - PPO (CT) - 02/24/06
(New & Improved S.)

Anthem Blue Cross - Century Preferred (CT) - 11/07
Doctors office handled the whole process after I provided them with the information they requested. Be prepared to provide long term supervised records of attempted weight loss. I think if you can show persistent behavior in trying to control your weight it is a large factor. I was able to provide 2 years worth of weekly weigh-ins at TOPS (Take Off Pounds Sensibly) along with several Weight Watcher books. (Helen W.)

Anthem Blue Cross & Blue Sheild of CT (CT) - 07/21/01
(Annette F.)

Anthem Blue Cross and Blue Shield of Connecticut - Century Preferred (CT) - 2006
It is sad to say that there is more open communication between the insurance company and me than the surgeon I chose and me. You make the connection. CORRECTION: They can be some of the biggest procrastinating liars in the world! Be sure to bug them relentlessly if you want this procedure done in a timely manner. (Pamela W.)

Anthem Blue Cross Blue Shield - POE- for State Employees (CT) - 09/13/01
Found out that today that you have to be medically supervised on a diet for the last 12 consecutive months, be obese for 5 years or more, and have comorbities. September 13, 2001 Thank God Approved after 4 days!! No stalling, meet the criteria and you will be fine. I didn't call them either it just took 4 days. (Carla T.)

Anthem Blue Cross/Blue Shield - National (CT) - 03/22/01
(Karen V.)

Anthem Blue Cross/Blue Shield (CT)
(Robin H.)

Anthem Bluecare (CT) - 9/23/2003
(Bambilynne B.)

bc (CT) - 10/26/05
(NINA K.)

bc/bs - ppo (CT) - 07/02/03
(robin w.)

BC/BS (CT) - 09/10/03
I didn't have to deal with the insurance at all but I was approved within a couple of days. (Karen K.)

BC/BS (CT) - 07/20/04
(Lisa M.)

bc/bs - bluecare (CT) - 07/13/06
(fisher t.)

bc/bs century preferred (CT) - 04/18/01
(Mae R.)

BC/BS Federal (CT) - 10/15/02
I talked to someone at the insurance company on a separate matter, and asked whether the paperwork from the surgeon had gotten there yet (it had been several weeks). The woman I spoke with was very pleasant, very helpful. She told me that they did not pre-approve, but that it is written explicitly in the provider book that the surgery is covered as long as the criteria is met. About a week later, I got a letter saying the hospital was precertified for a 2-day stay. At the time, the date on the letter did not match the date I had been given, so I called the surgeon's office. The woman I spoke with there said that it had been approved only the day before, and was surprised that I received the letter so quickly (also that the date was changed, and the letter was right). All in all, I was pleased with the level of caring I received about the whole procedure. (Dot R.)

BC/BS Federal Employee Program - PPO (RI) - 11/6/06
There was no problem watsoever with my insurance. The doctor faxed a letter of medical necessity, and they faxed back an approval code..simple as that! (Jill A.)

BC/BS of Mass. - Master Medical (NH) - 06/12/02
Insurance was completely taken care of by my surgeon's office staff. I received approval notice two weeks after my last surgeon visit. (Kris W.)

BC/BS State BlueCare POS (state employee) (CT) - 10/7/05
I had absolutely no problems. I called when I decided I wanted surgery to find out if it was covered - yes if medically necessary. Dr. Valin's office submitted everything for me, and approval took about 2 business days. (Nancy C.)

BCBS - ppo (CT) - 08/03/04
(E K.)

blue cross (CT) - 09/12/05
(millie s.)

Blue Croos (CT) - 07/01/04
(JoJo E.)

Blue Cross - Bluecare Plus POS (CT) - 6/21/2001
My docs office handled dealing with my insurance. I sent them a letter from my orthopedic doc stating medical necessity. Further, I sent prescription verification from the pharmacy where I purchased phen/fen several year ago, indicating I had been on a doc supervised program for a year or more. I could not locate the doc, the pharmacy records satisfied them. Insurance coverage was requested last Wednesday and the permission to proceed came today, Monday. (Linda G.)

Blue Cross (CT) - 01/10/01
From what the receptionist told me that dealt with the insurance company, I guess they have a specific policy of anyone with a certain BMI is automatically approved for the surgery. As I understood it, my insurance is one of the easiest to get approved. (Laura E.)

Blue Cross - Federal Employee Program (CT) - 02/15/2001
The first time I called, around Jan 20th, the first response was that the procedure was not covered, because it was considered cosmetic. Second time I called, same day, they said that if it was medically neccesary it could be approved. Well according to my surgeon, he's had no problem with them in the past, his office started seeking approval yesterday, (02/05/01). I guess it's the waiting game now. 02/15/01, I just got a call from my surgeon's receptionist, I got approved after 3 days. (Leonardo D.)

blue cross - ppo (CT) - 02/07/01
I have anthem blue cross of ct and it was no problem for office visits to be paid and i was approved over-night. my DR's office took care of contacting the insurence company and all paper work. (paul l.)

Blue Cross - Blue Care Plus (CT) - 10/09/02
It is like pulling teeth. They "move" very slowly and nothing is done unless you keep on their back and call on a daily basis. If you keep on them, then I think they are more likely to give in. Don't forget to get the names of the people you deal with so when you call back over and over again, you can as for them by name. Also, tell them you want to have a hearing in which you can come to be heard. (Barbara L.)

blue cross - anthem (CT) - 07/25/03
(jacqueline b.)

Blue Cross (CT) - 3/1/03
Thank goodness for the people in my surgeon's office! I was on the waiting list for my initial consult for six or seven months. I was seen in 1/03 and met all the surgeon's stipulations except my PCP refused to write a letter to support my surgery. She provided my patient chart to the surgeon but didn't want to write a letter. After holding my PCP held me up for two months, Debbie, the PA (and wife of my surgeon), submitted my information to the insurance company and I was approved within a week. She booked my surgery for 4/21/03. I thank God every day for Debbie's tenacity. Without her, I would probably still be waiting to have my surgery. (Danielle L.)

Blue Cross - POS (CT) - 09/25/04
I never had to 'deal' with my insurance company. Dr. Valin's office submitted what they required and my surgery was approved. (Stacey B.)

BLUE CROSS (CT) - 11/21/04
(Sandra C.)

blue cross - myself (CT) - 01/23/06
(nancy s.)

Blue Cross - HMO (CT) - 05/17/06
(Angela W.)

Blue Cross - BlueCare POS (CT) - August 2007
(Maria M.)

blue Cross & medicare hospital only - ppo (CT) - 10/18/01
(T P.)

Blue Cross Blue Sheild - BlueCare (CT) - 03/18/05
(Tracy Lynn M.)

Blue Cross Blue Shield - Federal (CT) - 04/17/01
Dr. Valins office submitted the paperwork to the insurance company on Friday afternoon 5/4 and approval came through on Weds. morning 5/9 (approx. 4 days because they don't count weekends). The Dr.'s office never had to make a phone call to push them along with approval. As far as medical problems I only had documentation for: 9 yrs. of visits to a Diet Doctor that gave me prescriptions for weight loss. Most of the documentation just showed weight (which maintained between 240-270) and BP which was always normal. Other than that I had record of degerated disk disease/arthritis in my lower back. Other problems I reported (but had no medical records to back it) were Asthma, joint pain, stress incontinence & failed diets (this is important to have as much as possible). (Lauri M.)

Blue Cross Blue Shield - POS or POE (CT) - 02/27/05
(Dina G.)

Blue Cross Blue Shield Fed Emp Program - POS (CT) - 02/01/01
(Debra N.)

BLUE CROSS BLUE SHIELD PRIMARY, CIGNA HBO SECONDAR (CT) - 09/16/01
I WAS TOLD BY MY DOCTORS OFFICE THAT BLUE CROSS WANTS 1 YR. OF DIETING MONITORED & DOCUMENTED BY YOUR PRIMARY PHYSCIAN AND A LETTER OF MEDICAL NECESSITY B4 YOU CAN BE CONSIDERED FOR THIS SURGERY. CIGNA HMO WANTS A LETTER OF MEDICAL NECESSITY. IT HAS BEEN 2 WEEKS NOW & I HAVENT HEARD ANYTHING. MY SURGERY IS TENTATIVELY SCHEDULED FOR 9.27.01! IF THEY DONT APPROVE IT SOON THE SURGERY WILL BE RESHEDULED. THE SURGERY WAS CANCELLED BUT I WAS FINALLY APPROVED AFTER 4 WEEKS. CECILIA IN DR. VALIN'S OFFICE WAS QUITE HELPFUL SHE HAD TO MAKE MANY PHONE CALLS TO GET THINGS ROLLING. ONE DAY SHE SPOKE TO FOUR DIFFERENT PEOPLE WHICH TOOK ABOUT 45 MINUTES TO GET THINGS FINALLY STRAIGHTENED OUT. (CHERYL B.)

Blue Cross Blue Shield State of CT Employees - PPO (CT) - 09/02/03
(Robert B.)

Blue Cross/Blue Sheild - Century Preferred (CT) - 09/03/02
(Lisa M.)

Blue Cross/Blue shield - blue care plus (CT) - 09/23/00
Sept.15- Believe it or not, I was approved in 4 days! I am still in shock over this. I did NOTHING to get this approval, other than meet with the doctor, the nutritionist, and the psychologist. That's it. The office faxed my info to them and they had an answer within 4 days! Unbelievable! I never even asked my PCP for a referral. (lynne s.)

Blue Cross/Bluecare - POS (CT) - 070802
My doctor's office handled everything. the response was very fast have all of your history ready for a fast approval (Sharon M.)

Blue CrossBlue Shield - HMO Blue (CT)
(Elida S.)

CIGNA (CT) - 03/18/01
CIGNA was wonderful. I was accepted within a couple of days from the time of submission. I included a letter from my primary physician that outlined co-morbidities from which I suffered. She also stated in the letter that she felt this was a necessary surgery. My Doctor also told them of the weight loss programs I had tried in the past with temporary success, i.e., Nutrisystem, Weight Watchers, Nutrition counseling, Optifast, etc. I would recommend that you have a letter such as this from your doctor when you first apply for surgical coverage from CIGNA. (Karen S.)

Cigna - HealthCare HMO (PA) - 07/03/02
Insurance stuff was faxed and 6 day later I called them just requesting a time frame in wich I could expect an answer this was a day before a holiday(4th July) and expected everyone on vacation the said another 5-7 working days. I thanked them 45 minutes later the doctor office calls and tells me every thing is all set. (Julie U.)

Cigna - HMO (CT) - 6/10/2002
Dealing with Cigna was hard, you really need to keep on them call every week it seems to move things along quicker. The people you deal with are very nice, but don't always know whats going on. I was told on a Friday that I was pending for more paper work, then on Monday when I called I was approved. (Deborah P.)

Cigna (CT) - 07/01/02
I was actually quite impressed with how quickly and efficiently they approved me. My doctor told me that he really did not think I would be approved because I was in perfect health other than weighing over 300 pounds. He said he would "be surprised if I was approved and not to get my hopes up". Then it was submitted and I got a call from my doctor 2 weeks later saying, "guess what? you are approved!". Wow-very shocked; and I heard bad things about Cigna. My doctor said that I am lucky I had a good person from Cigna who reviewed my submission from the doctor. Very happy with Cigna now of course. I didnt even have to submit previous diet history or anything. Why was this so easy? Was it meant to be??? (Barbara S.)

Cigna (CT) - march 17,2004
I recieved a letter stating that I needed to have be on a diet which was regulated by a doctor for atleast 6 mos- which I did for over a year. They also stated that I didn't fit their other requirements for needing surgery, which was still funny to me, because I had letters from doctors and all sorts of paper work that stated why I needed surgery. Luckily I got new insurence thru work, and I am gonna try again. I just think it's unfair to question surgery based on activity that I did complete. Obviously they didn't look at my charts. (Christa D.)

Cigna - Network (CT) - 9/30/04
In the beginning I received a lot of inaccurate information. I was going for the lap-band and had been told by several different representatives that it was covered. Upon the advise of the surgeons office, I requested a case manager who kindly informed me everyone else I spoke to was wrong! She sent me the guidelins, requirements and exlusions. I submitted for the band and was of course denied. I was however told that I did in fact meet their requirements for surgery, so I decided to have the RNY. After resubmitting, changing the procedure, I was approved with in a week. I have hear horror stories about Cigna, and although I did have a few problems, it took less than 4 months from when I seriously started considering this surgery to actually having surgery! My advise to anyone with Cigna is to gather your info, make sure you are informed and request a case manager! (Carmen S.)

Cigna Health Care - CIGNA (CT) - 01/19/02
Well The Dr Office send in the Papers to the Insurance on May 7, I called the insurance and its still pending, its being a week now. Debbie has done a great job sending my info in. 6/4/02..Feeling down..I'm still here waithing for insurance to aprove me, I don't know why its taking them so long am 45 days left till surgery. Am Just hoping to GOD that they wont denied me.. 6/12/02...Oh God I got a called from Debbie It was around 11am guess what? I GOT APROVED...Thanks to debbie who made lots of calls, and send the paperwork in 2 times to cigna. If it wasent for her I would still be pending..Thanks Debbie. (Hilda P.)

Cigna Healthcare (CT) - 07/17/01
Dealing with myInsurance was awesome! My Dr's office sent in my request for surgery on August 8th. It was sent to nurse review and I was approved August 10th at 2:30pm! YES!! They were wonderful! I only had to send my diet history along with the request for the surgery. (Lynn R.)

Cigna Healthcare (CT) - 10/04/01
I called Cecile a few times end of last week and beginning of this week. Yesterday I called Cigna and "Ramone" was very helpful. I asked if he knew when Cigna received the letter and he asked if it was ok to put me on hold. I said ok. Even though he kept me on hold for a while, when he returned, he gave me the name of the manager who reviewed my file, said I meet all the criteria, would say yes, but had to check with the Medical Director first. He said that they have it down as urgent and that she (manager) will get back to me by 5:00 yesterday. Well, I didn't get a chance to call them back yesterday but felt very confident. I called Nina at Dr Valin's office this morning and she said, yes I'm approved and she was surprised at how quick (and with no hassles). Hooray! (Sally ..)

CIGNA HEALTHPLAN of CT (CT) - 06/05/01
I work at CIGNA (Investments not Health Care)and have their Ins. but have been nervous about approval. The paperwork---List of diets, meds, medical history, letters from PCP (who documented 3 diets) and Dr. Valin, psychlogist and nurtristist was submitted 5/30 by Dr. Valins office and approved 6/5. (Bernice C.)

cigna of Connecticut (CT) - 02/20/02
We will see, I have read good things on the approval with Cigna (wesley b.)

Connecticare (CT) - 2/8/02
2/8/02 YIPPEE! I received notification from the State of Connecticut Insurance Office that Connecticare's decision to deny authorization for an open Roux En Y has been REVERSED. They found in my favor because I meet national standards for medical necessity of bariatric surgery. Ha! 12/11/01 They have been ever so polite in telling me to forget about it! I had my first appeal letter in to them before I even got the written notification. After being sent to an outside source, I learned that they never really requested some of the information that they needed and I could have provided. Now, I am appealing to the state level; they say it is highly unlikely that someone under 40 would qualify (hmmm...age discrimination?) and that unless I have diabetes, hypertension, or apnea I'm a no go. Let's say hooray for preventative medicine! I think it is a far better plan to wait until I have diabetes to risk an open surgery, don't you? My familal history is riddled with diabetes, hypertension, and apnea so it is only a matter of time. Well, I can play that game too...I have a consult for a sleep study January 3rd. Advice? ASK them to send you the criteria you must meet. (Laurie M.)

Connecticare (CT) - 02/05/02
(Debbie B.)

Connecticare (CT) - 03/29/02
(Kris L.)

Connecticare - POS (CT) - 05/07/02
I was prepared for a fight.They approved within days.Connecticare was very fast. (tina p.)

Connecticare - Pcp (CT) - 10/1/02
They were very good..I was expecting a fight. But they approved within a week..They told me initially that if there was enough medical documentation and a psychiatric evaluation included-it would be considered.I guess they believe me and the MD, therapist, psychiatrist, nutritionist and the nurse who did the assessment.... (Linda K.)

Connecticare - Personal Care Plan (CT) - 06/19/2003
I didn't have to deal with them personally. Dr' Valin's office handled everything. I was approved within 1 week. (Heather M.)

connecticare (CT) - 10/30/02
My insurance company has been wonderful throughout this whole process. They reviewed everything in a timely fashion. Follow all procedures that are necessary to insure that your company is aware of the necessity of this procedure. (jill f.)

Connecticare - HMO (CT) - 1/7/03
I had no problems with Connecticare. I followed the direction of Debbie she was arware of all the doctors for me to see. They submitted on thrusday and I called today tuesday and was told I have been approved for 1/17. They were no trouble at all. (Jennifer L.)

Connecticare - Hmo (CT) - 01/15/03
(Laura E.)

Connecticare - POS (CT) - 7/30/03
(Robert K.)

Connecticare - EPO (CT) - 8/11/2003
ConnectiCare has been great. Dr Valin's office took care of everything and they know what they are doing because I've had no problems at all. From the first time I spoke with Dr. Valin's office they stressed the importance of documentation. I received a letter from each of my doctors stating that my conditions were directly relatated to my obesity. I'm sure that helped as well. (Melanie J.)

Connecticare (CT)
I did not deal with Connecticare, my doctor's office took care of everything and I was approved after the first letter. They paid everything and the only thing I had to do was send my co-pays to the hospital and docs. It was simple and easy. (Callie S.)

ConnectiCare - Personal Care Plan (CT) - 07/22/03
I was approved after my information was submitted. I actually was unaware that it had been submitted and was pleasantly surprised to find I was all approved. (Beth C.)

Connecticare (CT) - 02/20/04
My insurance company approved after the first letter and all reports were in. I was amazed. It was great. (Mary B.)

Connecticare - HMO (CT) - 07/26/04
(Kim P.)

Connecticare (CT) - 09/11/04
I am thankful for such a wonderful insurance company. They were pretty fast about my approval. It seem almost immediately. (Paula U.)

CONNECTICARE (CT) - 10/04/05
(Lyneth L.)

Conneticare (CT) - 2/8/01
They were actually very good. At first they denied me because my dr sent me to a psychologist and there policy is for patients to see a psychiatrist. The day after my psych evaluation my case worker called me with approval. (Carolyn M.)

ctcare - personal care plan (CT) - 09/18/02
My letter was sent out on 11/13/02 and by 11/18/02 I called to check and I was told I was approved. No stalling from them. No extra information needed. It went very smoothly and I didn't have a hard time at all. (Tina T.)

Empire BC/BS - PPO (CT) - 04/28/05
No problems at all. Very cooperative. (Angela A.)

EPBA (RI) - 5/2/04
MAN! What a gut wrenching experience waiting for approval. Will I, won't I? The insurance company at first wouldn't even talk to the surgeon's office because there was a written exclusion policy. I wrote an appeal letter to the human resources person and didn't hear a thing for 4 weeks. Finally I got the call saying I was APPROVED!! Not only did they approve my surgery, but they made an ammendment to the plan so anyone needing the surgery could have it!! Awesome!! What a life saver. My advice.. have all of your info readily available and don't give up! (Michelle L.)

GE Health Care Preferred - Health Net (CT) - 03/29/02
(Christine H.)

Guardian Health net (CT) - 10/17/04
(Melissa G.)

Health Net - Platinum Advantage (RI) - 02/28/04
I did not have to deal with them at all. A consult with a specialist does not require a referal with this insurance so I made my appointments with the surgeon and his office actually did the rest for me they were very helpful. I was very happy with the way the insurance handled the entire thing. (patience s.)

Health Net - Charter (CT) - 12/03/01
The doctor called and got approval the next day. I never picked up the phone. (lynn b.)

Health Net - PPO (FL) - 02/27/02
The doctors office did everything, all I had to do is show my insurance card and I received the approval letter in the mail. Approved for a TT in less than a week. Once again Dr. Valins office did everything. (Linda A.)

Health Net - Healthy options (CT) - 01/07/02
(Stacey G.)

Health Net - PHS (CT) - 09/05/02
I have had no problems that I know of, but am still waiting confirmation from my Surgeon's office. 9/5/02: I received notification TODAY that I was approved after only 2 days! I am awaiting pre-op instructions and testing. I can't BELIEVE that I am finally going to receive the tools necessary to help me gain control over my life. HealthNet/PHS were great. I suspect that Dr. Valin's office had A LOT to do with the quick approval. For anyone who is frustrated, DO NOT GIVE UP! I had an appeal letter waiting in the wings "just in case". I found it on THIS website. There is an overwhelming amount of information out there waiting to be discovered if you take the time to do so. This has become MY FAVORITE site to visit and I do so EVERY DAY at least once! 9/05/02--more info: OK guys, here is the BIG news! I called my insurer on Tuesday this week, to find out what the status was. They informed me that they had just received my paperwork and that they would be reviewing it shortly. HealthNet/PHS is my carrier. They told me that my surgeon (Dr. Elmer Valin), would let me know how things would go; whether or not I'd be approved. They also explained that if it was done at a referring hospital (which is the hospital of my choice anyway), that I'd be covered 100% LAST NIGHT I RECEIVED THE E-MAIL FROM DEBBY THAT I AM APPROVED!!! I am set for 10/8/02 at the Hospital of St. Raphael's in New Haven, CT. I am waiting to here from Cecile (Dr. Valin's secretary) when my pre-op thorascopy will be scheduled. Can anyone out there tell me anything about this procedure? Believe it or not, I think I am more afraid of this then of being operated on! Also, does anyone have any comments about the port they insert into us (via the neck) while surgery is being performed? What is it like? Is it uncomfortable? What was the worst part of the entire experience? Please share if anyone can. For all of you guys who are still pending approval, my heart is with you. I was frustrated beyond belief. HANG IN THERE. If we are candidates, then they God will help us. I wish you all the best and hope for HUGE losses and great new beginnings! 9/27/02: ELEVEN DAYS TO GO! WHOOOOO HOOOO! I have finished ALL pre-surgery tests. They wer ALL a breeze and covered 100% by the insuance company! DO NOT GIVE UP! THIS SURGERY WILL CHANGE OUR LIVES FOREVER AND YOU CAN GET IT DONE! (Angie B.)

Health Net - Advtg Platinum (CT) - 08/21/04
According to the RN in my first visit, my BMI of 40 makes the surgery medically necessary by itself. I don't need to have any other co-morbidities. She indicated that if my BMI were less than 40, HealthNet would initially deny the claim and then probably come through on the appeal. (Julie N.)

Health Net (CT) - 06/09/03
I honestly didn't have to deal AT ALL with my insurance company. Dr. Valin's office handled everything. The only thing I needed to do was get letters from my physicians supporting the need for this surgery. (Melissa M.)

Health Net - Platinum Advantage (CT) - 03/28/04
(Maggie S.)

HEALTH NET (CT) - 07/08/04
(LINDA S.)

Health Net (CT) - 09/09/04
(Linda B.)

Health Net (CT) - 10/21/04
(Lucy D.)

Health Net (CT) - 12/2004
My experience with Health Net was wonderful compared to how the company is now. It is my understanding that they changed their poliy and as of Jan. 1, 2005. My plan will no longer cover the Lap Band procedure. A friend of mine was approved and then thy tried to take away her authorization because she had to delay her surgery due to medical reasons. I am happy to say we appealed and won. My friend has since had Lap Band surgery. I would be catious of this company in the future. (Maura D.)

Health Net formerly PHS - healthnet (CT) - 2/1/02
docter sent letter and i was approved in 2 days (shalonda s.)

Health Net -PHS (CT) - 03/22/04
(Hydi H.)

HealthNet - pcp (CT) - 11/30/01
I will keep informed when i know more. (Linda S.)

Healthnet (CT) - 12/24/01
Everything was handled by the Drs. Office and I was approved. I do understand that my insurer, Healthnet is the best one to have in my area for this procedure. When I was approved they were the only insurer covering the actual lap band mechanism. So again, I had the right insurance at the right time. (Jean C.)

HealthNet - CT Charter POS (CT) - 06/12/02
(Linda L.)

Healthnet - PPO (CT) - 09/02/02
(Shelley M P.)

healthnet (CT) - 09/19/02
i had no problems went right through (johanna c.)

HEALTHNET - advtg platinum (CT) - 07/14/05
(Sassy S.)

Healthnet - PPO (MA) - 7/19/2003
I did not have to deal with Healthnet directly, they surgeon's office did everything. It is a very fast insurance company when it comes to approving WLS surgery. (Holly T.)

Healthnet (CT) - 05/30/03
I had Healthnet and I honestly never even spoke with them. Dr. Valin's office took care of the whole thing. I'm not even sure what other physicians gave letters. I just got an email that said I was approved and off I went. (Catherine D.)

Healthnet (CT) - 04/25/04
(Bryan J.)

Healthnet - CT HMO Charter (CT) - 07/12/04
I have not tried to get approval yet, I have met with Debbie, Diana and Chris. I am now going for a ultra sound due to having a hernia. Next I will be coming to a pre op support meeting on 07/20/2004. (Tracey D.)

HEALTHNET (CT) - 09/17/04
(KAREN T.)

Healthnet (CT) - 09/28/04
(Elle R.)

Healthnet (CT) - 03/17/05
(Kristin C.)

Healthnet - Smart Choice (CT) - 11/03/05
(Susan P.)

Healthnet (CT) - 03/01/06
(Natalina M.)

HealthNet - PPO () - 6/9/08
(Janelle S.)

Healthnet State of CT Employee (CT) - 07/02/05
(Jenny S.)

Healthnet, formerly PHS (CT)
(Tina F.)

HealthNet/PHS (CT) - 9/5/02
I had no dealings with the insurance company at all. My doctor's office handled everything. I had my approval within a few days of the submission. What a relief. (Kathi R.)

INDPENCED BLUE CROSS - PPO (CT) - 08/03/02
THEY WERE NOT BAD THEY HAD A NURSE TAKING MY CASE COULD NOT GET IN TOUCH WITH HER BUT I CALLED EVERY OTHER DAY DOC CALLED IN PRECERT ON 7/9 8/1 APPROVED YOU MUST CALL OR THEY WILL STALL DONT WORRIE ABOUT THEM THEY COST YOU MONEY SO CALL ALL THE TIME AND (BUST BALLS) (philip c.)

Mashantucket (CT) - 04/22/01
They don't approve anything connected with weight loss. (Pam F.)

med span (CT) - 03/07/01
(April .)

Med Span (CT) - 07/30/02
They responded and approved in 2 days. (Deborah S.)

medicar/medicad (CT) - 02/14/02
(DONNA T.)

Medicare - Medicare (CT) - 08/31/04
(Anne B.)

MedicarePart A,B (CT) - 04/14/04
I have Medicare A/B I have not had to do anything extra.I get the surgery the Doc submitts the bill and Medicare Pays.Easy as that (Tasha J.)

MEDSPAN (CT) - 03/17/01
I got the approval within 4 hours. Medspan is not only a great insurance co but a wonderful employer................. (Sharon M.)

NALC (Postal Union Ins.) First Health Affiliate (MA) - 03/27/02
It's a postal union insurance...Only will cover 70% of doctor fee. Paid all but $3000 of the total costs. I paid out of pocket for the balance, but it was well worth it!This insurance requires you to be 100+ lbs overweight, with some medical conditions and proof of diets you've tried. My doctor's office said dealing with them was the worst experience they've had with insurance(which must be bad because it is a very busy docs office). Pre-Certify Dept called me today (03/28/02) to tell me the hospital and doc were out of network, but I saw my hospital listed in THEIR Provider Book! I got that corrected by phone. (They were spelling the hospital name wrong!) One week later,(April 5th) I got a letter APPROVING the surgery!!! :0) However, when I called the doc's office, they said the medical director still needs to approve the hospital stay! (April 9)...received call from doc's that ALL is now APPROVED! So it took about 2 weeks from first letter to final approval for both surgery and hospital stay. Very nice staff on NALC phones. A pleasure dealing with them as a patient. Doctor's office handled them as far as submitting paperwork, which made it easier to qualify. I made sure every stitch of information I had about my diet history and present health issues was included, which took a lot of running around and tracking old doctors. I am grateful they covered the bulk of the costs. :0) (Kathy A C.)

Oxford - Freedom Plan (CT) - 02/19/02
(Tiffany W.)

Oxford - Freedom Network (CT) - 04/06/01
(Tracy .)

Oxford - FREEDOM (CT) - 04/30/02
04/12/02 I sent a five page appeal letter, referencing every diet and diet pill I had ever tried, every piece of exercise equipment I had ever bought, every illness anyone in my family had ever had. I mentioned my parents, siblings, aunts uncles, cousins, and grandparents. I reference statistics from the news articles I found on Association for Morbid Obesity Support web page. Dr Brodie, my PCP, sent an appeal letter on my behalf. Elizabeth Baxley found a report from Oxford Insurance Company. What was stated in the research report is the following: Oxford determined that for every dollar they spent on obesity surgery, they would save around ten dollars on illness issues that would be avoided. Dr Valin's office not only sent an appeal letter but had additional blood work done to back it up. It took about three weeks for the Insurance Company to send the Appeal’s Acceptance letter. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 02/28/02 I have been denied. Debbie from Dr Valin's office, stated that she would assist me in the petition. Oxford said I was not suffering from any life threatening illness that would warrant this surgery. (Lynette D.)

oxford (CT) - 12/21/05
(michelle a.)

oxford - freedom plan select (CT) - 2/10/2007
AMAZING - OXFORD APPROVED ME FIRST TRY (Julie H.)

Oxford Freedom (CT) - 05/06/02
(Sabrina D.)

oxford health (CT) - 02/05/02
(Tammy F.)

Oxford health - Freedom plan (CT) - 04/29/05
(ladychuggs M.)

OXFORD HEALTH INSURANCE (CT) - 07/21/03
I had no problems getting approved for the surgery. The doctor's office took care of it all. I did not have to do a thing. (SARA R.)

Oxford Healthcare (CT) - 1/26/07
Dr. Valin's office submitted in the paperwork, then called to inform me that I was approved for surgery. I believe because it was medically necessary that they approved it on the first submission. (Alyssa S.)

patricia cardona - cigna healthcare (CT) - 02/27/01
my insurance company requested letters from 3 different weightloss places where I tried to lose weight. (patricia c.)

phs - select pos (CT) - 05/13/01
(Laura R.)

PHS (CT) - 06/20/01
I did not deal with PHS directly, dr. valins office handled everything. I heard that PHS is the best coverage to have for this surgery! (Kim S.)

PHS - Charter (CT) - 06/24/01
Unfortunaley, I haven't dealt with them yet. So I have a surgery date, an I am unsure of the approval or not. I spoke with Dr. Valin's assistant over and over again, and she continues to say, it will be fine. So we will see (Debbie L.)

PHS - Charter (CT) - 07/13/01
I have never had any problems with PHS as far as any thing I or anyone in my family has ever needed done. I feel very fortunate to have an insurance company like them in this day and age. (Teresa M.)

PHS (CT) - 10/03/01
PHS was fantastic. Their policy is to answer withing 24-48 hrs of request. My secondary insurance was Aetna UsHealthcare and they gave approval within 5 business days. Both companies were wonderful !!! I would advise anyone to use either company (Marcy R.)

PHS (CT) - 05/12/02
(D K.)

PHS (Health Net) - charter hmo (CT) - 06/29/01
My Dr's office waited for the longest time to send the darn letter out!!!!!!! But, once they did, the approval was amazingly fast! The letter was sent on Tuesday night & I had my ok Thursday morning! I feel very lucky that I have them as my insurance company. I have seen what other people have had to go through. (Renee D.)

tri state teamsters anthem blue cross (CT) - 02/28/08
must be enrolled in their take charge program for 6 months (Cheryl F.)

tri-state teamsters - Union/BCBS Managed/Self Insure (CT) - 12/31/04
They were wonderful. I did have a mandatory 6 month "Take Charge Program" to partake in but it was easy. All I had to do was tell them of the weight loss things I have tried and keep in touch with them via phone and e-mail to let them know how I was doing. They supported me every step of the way. The 6 months was basically just to make sure you have really thought it through and gave it a good try on your own. I started in July 04 and they have called me and e-mailed me on Dec 31 to let me know my approval letter was on the way a WONDERFUL New Years gift! And I did het it today on 1/3. I only wish everyone out there had it like me. (marie s.)

United Healthcare - POS (CT) - 10/15/02
The doctors office took care of it all. (Faith H.)

United Healthcare - Select Plus POS (FL) - 02/17/04
I called to check almost 3X/week, not sure if it did any good, it might depend on who you get to answer the phone. My last call the woman said she "will put an email into the file to expedite" and within 2 days I was approved. (Debra P.)

United Healthcare (CT) - 09/14/04
I was informed that they are "out of network" so they would pay 80% as long as the patient's BMI is 40 or greater OR if their BMI is 35 or greater with 2 co-morbidities and that hey have a 30-45 day review period. I was approved exactly 2 weeks from the day my Dr's office faxed them the request. No problems at all so far -- I had a very positive experience! (K J.)

United Healthcare (CT)
(Amy K.)

United HeathCare - Options PPO (CT) - 3/7/02
My surgeon's office communicated with United Heathcare on my behalf. The day that they approved me, a nurse from United contacted me to ask if I had someone to help me at the hospital and after, to remind me of the importance of supplements/vitamins, etc - and to offer assistance if I needed anything! I was incredibly impressed with their response time and professionalism! (Jenifer K.)

Unitedhealthcare - Patricia Rist (CT) - 07/26/06
(Pat R.)