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Post by mindyntexas on Apr 27, 2012 17:33:23 GMT -5
Does anyone have any experience w/ the PCIP ( Pre existing Insurance plan ) actually paying for a revision ?
I am considering getting this insurance, I know they pay for sleeves as first surgeries. Its a little pricey $300 a month for just me .
I have called them three times and they said they DO pay for revisions I just cant find anyone who has actually gotten it approved through them ? Anyone ?
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Post by anniemck13 on Jun 16, 2012 22:44:35 GMT -5
I have been in contact with the bariatric coordinator with PCIP this week and she said that they will cover revision, and that I may not even have to wait the 6 months weigh in/diet because it is a revision, and i have notes from the last year and a half.
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Deleted
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Post by Deleted on Jun 17, 2012 13:29:58 GMT -5
PCIP in California denied coverage for mine but so far they have covered two of the three hospitalizations I've had for complications (the third one may so be covered but since I only got out of the hospital yesterday, I don't have official confirmation yet). Though not fun, it's a lot easier to budget and self pay for a revision and have the safety net of PCIP to cover labs, bone density tests, medication and the whole host of unknowns that may evolve afterwards than to be without insurance in the aftermath of a revision.
Worth considering as you make your decision.
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Post by anniemck13 on Jun 30, 2012 11:52:56 GMT -5
If ya don't mind me asking, why did PCIP deny your revision? I have talked to Sandy several times over the past couple weeks to get everything in order, and all is good thus far for approval is what she said. Going from Band to DS.
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Post by Deleted on Jun 30, 2012 16:30:32 GMT -5
If ya don't mind me asking, why did PCIP deny your revision? I have talked to Sandy several times over the past couple weeks to get everything in order, and all is good thus far for approval is what she said. Going from Band to DS. PCIP *will* cover revisions, they just *didn't* cover mine. The reason given was 'Not Medically Necessary' but that's a big broad reason, right? So really I don't know. But I can tell you that I hadn't had health insurance in years and so did not have a long, solid medical history to show compliance or complications over time. I may have been able to wait and get it all covered but I decided that if they weren't going to approve the surgery with my BMI of 50 and raging diabetes that I'd just learned was back with a vengeance (after years of post-RNY remission), that I didn't want to spend my energy fighting them in advance. I moved forward with the surgery I knew I needed and intended to fight them after the fact. The good news is PCIP has deemed all my medical issues since then (which are all post-op complications) as medically necessary, so they're covering things. So as you can see, just because they didn't cover mine doesn't mean they won't cover yours... it also doesn't mean you can absolutely trust what you're being told on the phone, but we all know that. Let us know as the process unfolds for you. I'm pulling for you! |
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Post by anniemck13 on Jun 30, 2012 17:16:22 GMT -5
Ok... I get it... I haven't had insurance since 4 months post band. Only time I have been seen by a doc since then has been in the ER 3 times. Once because I was vomiting blood. Once because NOTHING including water would stay down and they unfilled me; and just this March due to the Vagus Nerve pain and thinking I was having a heart attack. so 3 times in 2 years. Other than that last visit with surgeon was 10/09.
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