Kaiser Insurance Anyone deal with them?

cheri123
on 7/28/03 3:05 pm - Aurora, CO
Hi, My name is Cheri. I had my surgery with Dr. T on 3/26. My brother is thinking of having this surgery but he has Kaiser. I've heard Kaiser has some sort of process of their own and would welcome replies from anyone who is familiar with it. Also do they use bariatric surgeons or just general surgeons? Thank you so much!
Terry W.
on 8/1/03 3:49 pm
Hi Cheri. Does your brother live in Colorado? I was going through Kaiser last year. At that time, they required everyone to go through their weight management program. That consisted of a quarterly visit with one of their weight management staff. So that was 4 meeting in 1 year. No exceptions. Also, within that year, you had to attend 2 classes offered by the American Heart Association. On was called Slim for Life and the other was Active for Life. One dealt with the American Heart Association's diet and the other was to add exercise to your life. The Slim for Life was not geared toward weight loss surgery at all. It was a 10 week class. Each class was 1 hour. I did not take the exercise class, so I am not sure about that. There were support groups that could attend and would have to be attended at some time in that year. After the year was up, then your case would be reviewed. Only after all that was completed would you be considered for surgery. Then you would have to wait until the review board would meet (maybe once a month) to be approved. Then you would get an appointment with a surgeon. So, you see, this process can take up to 18 months for completion. A very long, drawn out process. Since my employer is dropping Kaiser at the end of 2003, I went to United Health Care. Sad to say, we have a written exclusion in our policy, so I am still fighting for approval. Those that get approved in a week or two, should be very thankful. Sorry for the bad news on Kaiser. Hopefully they have reviewed and changed their requirements. Hope this helps.
Willow S.
on 8/26/03 2:52 am - Arvada, CO
Hi, I have Kaiser Insurance here in CO and have just begun looking into their WLS program. While what Terry posted was at one time acurate, their policy about WLS has changed. Now, instead of going through their weight management program, they have created their own steps for qualifying and readying their patients for the surgery (though it is still under the umbrella of their weight management program). I had to request info about their program and received, within a week, a pamphlet about their policy and questionnairre asking about my stats (i.e. height, weight, med history, current medications and attempts at weight loss within the past ten years, etc.). So far I'm at the point where I've turned in the survey. This is what they say happens after it is received. It goes before a panel to determine the patients eligibility for the surgery. Once approved for surgery, they're put on a wait list , which they say can be at least a year out. Overall, they say the wait from inquiry to surgery can be over two years long and there's no way to speed up the process, even if there are dire medical conditions. When it gets to be about six months prior to surgery, they require that the patients attend a twelve week course, that includes topics on exercise, nutrition, emotional support, etc. Once the class is completed, they then get to consult with a surgeon. Right now all surgeries for members in the Denver area are done at St. Joseph's Hospital. As far as I know, there are only three surgeons, general surgeons that is, and they only do open procedures, no laps. As far as aftercare goes, I've heard that Kaiser does not have any kind of program other then post-surgery check-ups. Hope this helps, Willow
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