Insurance Question

Hi all You might think this is a dumb question, however, I will ask it anyway. I would like to see other people who have the same insurance as I who live in Michigan and so I can read about their experiences with the insurance company. I thought it was a search function on this board, but I have not found it. If someone can either point me in the right direction, that would be terrific. Thanks! Sally

Hi Sally........not sure if there is site for that, but what Ins. Co. do you have?  I have Priority Health PPO. colleen

Sally, get the procedure codes from your dr office, and call your insurance.  They can give you definate yes and no what is covered and what you will have to pay. I was very surprised when I called mine.  I have UHC, and only paid for my co pay for my first consult.  everything else was covered 100 % Bext of luck  Pam

Thanks for your responses! I did call and got the "guidelines" in order for it to get approved. I was looking for statistics and possibly someone who might have the same insurance. My insurance is Blue Cross Blue Shield Community Blue (ppo) . I know they approve it, but I wanted to get some insight as to the "hoops" we have to go through in order for it to be approved. Sally

Hi Sally. I am from St Clair Shores also. I have Lumenos BC/BS

We should have a SCS weight loss party!!!  Where you at Jon?   LOL

I have Lumenos Blue Cross Blue shield

That is what brought me to this site in the begining 1. Go to the home page  under the SHARE box  click on YOUR INSURANCE.

 When the map comes up click on your state and you can search aphabetically . But alot of them are old posts early 2000's                     Good Luck  I hope you get approved I have to wait till Jan

BCBSM Community Blue does not require pre-authorization.  They have a clinical critera that you must meet.  As long as you meet this critera and your surgeon can document it, they will do the surgery.  All paperwork is sent in after the surgery is done.  You will want to call your surgeon and get the procedure code that they will billing.  It is a 5 digit number that starts with a 4.  Also ask for the diagnosis code.  It should be 278.1 (or 278.01).  Then call BCBSM and make sure your specific plan pays for weight reduction surgery.  

I got to this site looking for ins info also and noticed that it has not been updated in a few years.  I have bcbsm and I know that they have criteria to meet.  One is a 12 month diet and weigh ins.  I have not done that but I was diagnosed with pseudotumor celebri.  It is a build up of fluid on the brain and it can be caused from being obese.  Mine is putting pressure on  my optical nerve and causing vision loss.  The surgeon wants to do WLS immediately.  The problem is were are waiting for bcbsm to waive the 12 months and approve the surgery.  Has anyone heard of them doing this?