Hi I need all the help I can get

I just found this forum , my name is Sherry I have thought about getting the weight loss surgery for years now ..but with insurence problems never could aford it ..I have finnally desided that this is the most inportain thing to me and I am going to find a way to get this surgery done ..I am over 300 pounds and have been over weight sence child hood, I can not remember ever being below 200 .. I have been to the dr and she recomends me getting the surgery done but I need to get insurence quick ..thats where i need the help now is blue cross blueshild a good insurence for this in michigan ? please if anyone can help me with advise would mean the world to me . waiting to hear from you ..Sherry

I always heard bcbs is best for getting approved, but i'm not sure how much it is out of pocket. make sure there are no exclusions also. Hugs Linda

My surgeon and the program director both said that BCBS are the best. They approve you right away for surgery. Beware...stay away from Blue Care Network; even though they are run by the same people they are the worst in terms of getting approved. Best of Luck! Stacey

Welcome Sherry, You will find that this fourm to be a good starting place to get the needed information for WLS. I agree with BCBS being easier to get approved. You will still need the Dr suppervised diet history anywhere from 6 - 12 months. Good luck and have patience as you will see many ups and downs when getting the needed criteria for WLS. Take care, Janice

I have BCBS PPO and all I had to do was meet the guidelines, no preapproval necessary. Your surgeon should know the guidelines and can advise you. My out of pocket was a total of $550 out of a $22,000 bill (surgeon, hospital, etc). The $550 was for 4 weeks worth of food, 1 co-pay for surgeon ($15) and 1/2 of the psychological eval and 1/2 nutritionist.

Sherry: Welcome to the group! This is a great place for information. I would suggestion check out the Insurance forum here on OH. They have some very knowledgeable folks over there and have experience with many types of insurances and the difficulties people have had with each. I have BCBS of MI (PPO) and as long as I meet their requirements then I'm approved. The one thing you need to be working on if you haven't started already is the doctor supervised diet history. My policy requires 12 months. Others are only 6 months. This is something they won't budge on. I'm not sure how you plan to get insurance ... just be warned that it's pretty difficult to buy a policy that will cover WLS. Most individual plans will probably exclude that coverage. I'm not an expert, by any means.... but definitely ask the folks in the Insurance forum for help on choosing which company to pursue. Also - as for research about the surgery itself. I found the BEST resource for every question I had was a book called "Weight Loss Surgery for Dummies". I've read it through once and now use it as a reference regularly. Good luck! Pam

thank you all for all the advise ,..I called bcbs and thay said I could get medical for 170 a month and then I would end up payingaround $4000 altogether she said , and thay would cover the surgery after 6 months , do you think that sounds right ? I mean it is more than worth that to me ....you no ..I can not afoord the whole thing this way I could at least have it done. Sherry

Hi Sherry! I'm new here too. It took me a year to meet the guidelines for surgery in Grand Rapids. I was with Grand Valley Health Plan and after a year, they refused to cover it. I ended up covering it myself 3 weeks ago today. I think it will be worth it since my quality and quantity of life were rapidly diminishing. I really didn't think I had a choice. I was pre-diabetic, I had high bp, bad knees and ankles, etc. Then there were the psychological reasons, depression, reluctance to go out in public looking like this, etc. Class reunion? NOT ON YOUR LIFE! One thing I did discover: if you are private pay and ask for a discount, you may get one! The hospital gave me 20%, the anesthesiologists gave me 25%, and the surgeeons and their clinic gave me 30%. I just called them as soon as the bills came in and asked for a discount for prompt payment. It all helps a lot! Here Mesa seems to be really good at covering the surgery. Teachers and school workers have Mesa. Even their bus drivers have Mesa and can have the surgery. Good luck with the process. It sometimes seems endless but it's worth it. I'm down 30 pounds already! Yippee! Hang in there and take care of yourself. Put yourself first for a change! Gloria