Insurance

As many of you have heard a number of insurance carriers are threatening to, or have already stopped paying for gastric bypass surgery. Because Blue Cross Blue Shield has so much of the health insurance market in Alabama we seem to hear more about Blue Cross than other carriers. Blue Cross is now implementing a new medical policy that would make it difficult for many people to be approved for surgery. I have also heard that Blue Cross and Blue Shield in some other states is no longer covering gastric bypass surgery. (Georgia & Florida) Those of you (like me) who have had the surgery, know first hand the tremendous health benefits we have received following gastric bypass surgery, and it concerns me greatly that many people will no longer have the health insurance coverage which will allow them to experience the same health improvements we have experienced. I would be interested in hearing from you regarding your experience with you insurance carrier. Who is your carrier? Does your carrier cover gastric bypass surgery? Does your carrier plan to stop covering gastric bypass surgery? Was it difficult to get your carrier to approve your gastric bypass surgery? We should have a voice in the decisions that these companies are making! I believe it is time that we take a stand in what we believe! Thank you in advance for taking the time to respond to this important matter. Skinny Wishes and May God continue to bless each of you no matter where you are in your journey. Becky PS I apologize in advance if this shows up repeatedly for I am going to be posting this on all boards.

HI I JUST HAD MY SURGERY AUG 26TH IN LOUISVILLE KY. I'M AN EMPLOYEE OF BELLSOUTH, WHICH ALSO MEANS I HAVE BLUE CROSS BLUE SHIELD OF ALABAMA. I ONLY HAD ONE REJECT LETTER AND THAT WAS BECAUSE THE DOCTOR SENT THE WRONG CODE IN. YOU SEE BC/BS DOES NOT WANT TO PAY FOR THE LAP BAND PROCEDURE BUT DID APPROVE MY SHORTLIMB RNY. AFTER THE DOCTOR RESENT THE CORRECT CODE..AND I CALLED MY UNION REP VP..I GOT A REAL SWEET CALL FROM THE BC/BS THAT TOLD ME THEY HAD EXPEDITED MY PRE-DETERMINATION AND I HAD BEEN APPROVED. THAT WAS JULY 22ND. GOT THE OFFICIAL LETTER JULY 26TH. HOWEVER, MY GIRLFRIEND IN THE SAME OFFICE WITH THE SAME INSURANCE WHO STARTED OUT EXACTLY 2 WEEKS BEHIND ME IN THIS ADVENTURE (MY 1ST APPNT MAY 19TH-HERS JUNE 2ND) THEY HAVE DENIED HER TWICE..OF COURSE THE "SAME" DOCTOR SENT THE WRONG CODE IN TWICE!!!! AND NOW THEY ARE TELLING HER THAT THE GUIDELINES HAVE CHANGED EITHER 10-1 OR 10-18 OR 11-30!!! NO ONE REALLY KNOWS FOR SURE..AND SHE'S REQUIRED TO PROVIDE 5 YEARS OF MEDICAL HISTORY (SHE PROVIDED 6 YEARS) AND SHOW 6 MONTHS WORTH OF WEIGHT LOSS UNDER A SUPERVISED PROGRAM. THE UNION VP IS WORKING ON HERS NOW..BUT ALAS SHE MAY RUN OUT OF TIME THIS YEAR..AND OUR NEW DEDUCTIBLES WILL BE THRU THE ROOF NEXT YEAR. MANY SKINNY WISHES TO YOU...I'M DOWN 60LBS??!!! AND FEELING WONDERFUL..EXCEPT I BROKE MY ANKLE 10-31..BUT MY GUTS DIDN'T FLY OUT!!!! RENEE