Anyone have Anthem BC/BS PPO?

I am just wondering how the approval process was, and the out of pocket expenses you incurred. There is a $7500 lifetime cap for bariatric surgery and I am kinda confused what that means. Any info would be appreciated!

I have Anthem BC/BS HSA with the same lifetime cap. That means that they only pay $7500 MAXIMUM towards your surgery and any complications that may arise. Also, they only pay that much if your surgery is going to be at a Center of Excelence. In my case my Dr does not do surgery at a Center of Excellence (according to them, I found Sky Ridge to be nothing short of super!) so therefore the maximum they would pay was $1500. I ended up not going thru insurance and doing self pay because my deductible is $5000 yearly, so basically I wasn't going to get any help from my insurance coverage.

I was under the impression if you went to a Dr in their network and it was a Center of Excellence, the Dr's actually contract with Anthem to cover the 7500. That's at least what an insurance person told me. Is that not what you heard?

Yes, that's how it works, but it also has to do with the hospital. My DR works out of Sky Ridge Med Center and they have not yet contracted with BC/BS to be a center of Excellence.