Blue Cross Blue Shield of GA

Does anyone here have BC BS of GA? I am about to get a new job right in the middle of getting approved for surgery and I wanted to know the requirements for GA insurance. If anyone knows, please post. Thank you, Catherine

Hi Catherine, I have BCBS of GA and had surgery in July 05'....They require a diet history, 2 letters from your Doc 1 saying that it is medically necessay and one giving you medical clearance. You will also need to have a Psyc evaluation and some blood work. Not sure what surgeon you are going through, but I went through Emory and that is a requirement from them already so it kills 2 birds with one stone. Also check your policy, they may have some exclusions and whatnot. The best thing to do is call them and ask if it is covered under your policy (this is what I did, it took them a couple of days to review everything and when all was said and done BCBS of GA paid everything but roughly $250.00(this was for a nutrition class and an upper GI to look at tummy to make sure no problems with it) Also, keep on them after the paperwork is turned into them keep calling to see if everything was approved...They approved me in April and didnt get my letter to me until the end of May and I had to have the surgery done no later then 7/5...so that put pressure on my surgeon, I had the surgery on 7/5 the last possible day that I could have it. IF you have any questions please dont hesitate to email [email protected] Good Luck Erica

Thanks, I don't know yet what the policy is so I can't look it up yet. But I will as soon as I get it. So, does GA require a 6 month Pre-op supervised Weightloss program by a physician? AL does and that is my current insurer, because, I live in GA and work in AL. Thanks, \Catherine

I have BCBS of Georgia POS and they didn't require a 5 yr. supervised diet, actually the listing that I put on my Dr's paperwork of diets in the past were what they took as my diet history. I also had to get a medical clearance from my PCP, psych eval, nutrition consult, ekg and that was it. The whole process seemed pretty easy to me. Hope this helps, Melissa

They wanted like a 5 year history, not necessarily one that wa supervised my the doc...I went back as far as I could remember giving estimated dates with the date or exercise program I was on at the time(I went all the way back to when I was in jr. high, mom had put me on Jenny Craig as much begging her to do it...she finally gave in and boy was that a crash diet from hell) anything that you have done to try to lose weight the further you go back the better you are...also make sure that your PCP puts in his/her letter any co-morbities that you may have (for an example, I was 100% insulin dependant before surgery and diabetes was getting worse everyday, I was also getting into problems with my heart and possible sleep apnea....the diabetes alone was enough for BCBS (I think they started looking at the big picture and all the money that they would save on me in the long run))

Great! Thanks for your help! Catherine

I had BCBS of GA HMO when I had surgery in Dec 02 but my uderstanding is as of Jan 06 it is not a covered benefit for any company. Marie

I'd heard BCBS wasn't covering WLS in GA anymore.

I had BCBS of GA when I got my surgery in September 2004. They required alot of tests, 2 letters from PCP giving clearance and showing medical necesity. On a sad note...I also heard they stopped covering the surgery for GA patients July 2005 which is why many people only had a short time to get the surgey or it would not be covered. HOWEVER there is a light at the end of this tunnel... By GA law they still have to provide coverage for WLS.. Your employer has to elect to include the extra coverage for it. They are charging an arm and a leg to add this provision so many employers will not add it for you.

Tracey .....that was BCBS state merit that stopped covering in July 05, I have BCBS POS and had the surgery in Oct. and you are correct it is the companies decision whether to elect to carry it or not. Melissa