Mayo Insurance

[Guest guest]

Hi All,

My name is and am pre-op. I'm 44 and weigh 475lbs(?), with a BMI

of 59(?). I recently made my decision to have WLS and specifically

DS/BPD. I've just started the process, but I've seen my PCP, and have an

appointment with the endocrinologist on 4/25.

My insurance is Mayo Health Plan Arizona, and was wondering if anyone

has had any experience with them and WLS?

I appreciate the experiences that you all share, and am looking forward

to being on the other side with the rest of you post-ops.

Thanks,

[Guest guest]

Hi:

I also work for a division of Mayo Clinic - Mayo Comp is exclusively

for Mayo Clinic system employees - one of my workers and I were the

first two they ever approved for the DS. Unfortunately, no surgeon in

the entire Mayo system does the DS so we had to go out of network.

The Mayo Health Plan in Florida doesn't pay for any type of WLS (many

of my co-workers switched to Comp just for that reason) so is

blessed that they do in Arizona.

P

pre-op BMI 52, wt 322

May 29th, Dr. Kim, Ocean Springs, MS

In duodenalswitch@y..., kateseidel@a... wrote:

>

> > My insurance is Mayo Health Plan Arizona, and was wondering if

> anyone has had any experience with them and WLS?

> >

> ,

>

> The OSSG insurance site listed the following information on Mayo

> Health (looks like they're pretty cooperative, at least for the

RNY):

>

> Mayo Comprehensive

> Approved after first letter (12/01/00)

> Open RNY

> Weeks to approval : 2

> Pre-Op BMI : 50.1

> Comorbidities : hypertension, family history - heart disease,

strokes

> Policy : Must be medically necessary

> Comments : It took some time in getting it approved. But after the

> information was put together, it only took 2 weeks for approval.

> There was no stalling involved.

> Source: bgozney@y...

>

> --------------------------------------------------------------------

-

> Mayo Comprehensive Health Plan

> Approved after first letter (01/13/01)

> Open RNY

> Weeks to approval : 3

> Pre-Op BMI : 39.7

> Comorbidities : hypertension, osteoarthritis, sleep apnea, asthama,

> fibromyalgia

> Policy : Must be medically necessary

> Comments : I work at Mayo Clinic and feel very fortunately to have

> their medical coverage. Because I met the criteria and have the

> comprehensive plan, I was approved quickly.

> Source: mosqueda@p...

>

> --------------------------------------------------------------------

-

> Mayo Health Plan Arizona (MHPA)

> Denied after first letter (10/31/00)

> Open RNY

> Weeks to approval :

> Pre-Op BMI : 42.5

> Comorbidities :

> Policy : Written exclusion policy

> Comments : My denial letter stated that, they are complying with My

> companies exclusion, however there is an exception to the

> exclusion...failure to body organ which results in life threading

> health risk

> Source: dldutton@u...

>

> --------------------------------------------------------------------

--

> Mayo Health Plan AZ (HMO)

> Approved after appeal letter (01/14/00)

> Open RNY

> Weeks to approval : 1

> Pre-Op BMI : 51.3

> Comorbidities : Sleep Apnea

> Policy : Must be medically necessary

> Comments :

> Source: jmfrederick02@h...

>

> --------------------------------------------------------------------

-

> Mayo Health Plan AZ (PPO)

> Approved after appeal letter (First letter '99, 2nd 6-8-00)

> Open RNY

> Weeks to approval : 52

> Pre-Op BMI : 61.6

> Comorbidities : Sleep apnea, hypertension, chronic back, ankle

pain,

> diabeties, PCOD

> Policy : Written exclusion policy

> Comments : MHPA is a great insurance although of course I had to go

> through the normal jumping of hops to get the surgery approved they

> finally did say yes.

> Source: Tochatty@a...