New to the site!!

Hi all! My name is Kristin and I have been lurking for awhile, but I just made my account for this site.  I am 30 years old. I went to a seminar at Hurley in December and I decided on the Vertical Sleeve.  The problem I am having is my insurance is BCN HMO and I needed a PCP referral.  I hadn't been to a doctor in three years, so I found one nearby and made an appointment for a physical.  She started talking about how I needed to lose weight and I mentioned WLS.  She let it be know that she doesn't agree with the surgery and thinks I can do it on my own and then said insurance won't cover it anyway.  I told her that I had already checked and mine does.  She then told me she wouldn't do a referral for at least six months.  My BMI is 53.3 today, it was 54.7 when I first saw her.  Am I being unreasonable for thinking she should write me a referral?  It has been a month now and I am on medication for all the things wrong with me.  I also found out the my insurance won't cover Hurley, so now I'm looking at Henry Ford in Detroit.  Did anyone go through there who could give me info?

Thanks and remember to be nice I'm still new!!

Welcome to the board,

I went to Dr. Genaw at Henry Ford.  He is a very nice man, straight forward and not affraid to tell you what is on his mind.  His staff was very good as well.  My hospital stay was very pleasant.  The nurses were wonderful and on top of everything.  As far as your pcp I can not help any.  She may just need to follow basic rules to cover her butt.  She also may not want you to "rush" into anything.  Don't give up, it takes time to jump through all the hoops. 

Welcome Kristin!

I had my surgery at Henry Ford.  Dr Genaw is a great dr.  He is straight forward and tells it like it is but he is also supportive.  The entire staff there is wonderful and supportive.  As far as your PCP goes, a PCP should be someone you can trust and talk to.  If you are having issues with your PCP then maybe you should find a different one.  This is your health and your life we're talking about here and whoever your dr may be you need to feel that you can trust them with your life!

If you go to the BCN website it does list all the center's of excellence for Bariactric Surgery and Hurley is listed. I hope this helps in your search. You may have to search for another pcp that is willing to give you a referral sometimes checking with the specialist would help in yor search for a pcp that's willing to write a referral.


As Yes I know for a fact that all this are in Network for BCN.

Centers

• Borgess Medical Center, Kalamazoo
• Harper University Hospital & Hutzel Women’s Hospital, Detroit
• Henry Ford Hospital, Detroit
• Henry Ford Macomb Hospital – Warren Campus, Warren
• Hurley Medical Center, Flint
• Mercy Health Partners, Muskegon
• Munson Medical Center, Traverse City
• Spectrum Health Blodgett Campus, Grand Rapids
• St. John Macomb-Oakland Hospital, Madison Heights
• William Beaumont Hospital, Royal Oak

I agree with finding another PCP. Not for the fact that she will not help you, but, for the fact that he/she will be a big player in your new life and new health and well being. You need to have confidence in your new follow up care as well as your bariatric surgeon. It might be she has not been eductaed enough in the surgeries to understand what is expected.

You might try contacting the hospitals in your area or where you might be selecting for your surgery and see if they have someone in your area to reccomend.

Good Luck

Omg - I just want to say Hi and good luck and find a new PCP.  Especially since BCN waives the 6 month time constraint with people who have a BMI of 50<.    Only to have her impose a 6 month time constraint.  ridiculous!!!  Good Luck!

Thank you all for your posts.  I am seeing my PCP on Feb 8th and I am going to talk to her about it again.  I feel better prepared because I have since called my insurance and now have their packet defining what is and is not covered.  I hope she will agree, or I probably will have to find a new doctor.  Also, Kells, I thought that Hurley was covered too until I called my insurance company.  There are asterisks by some of those names and that means they are only covered for BCN Advantage insurance.  At least that's what they told me. 

Thank you again

Kristin

I hope and pray that she will be on board with you.    My PCP wasn't wild about the idea - but he hasn't tried to hamper me - he's being cooperative.  Good Luck!

I have BCN (HMO) also. I am just in the beginning stages of trying to get approved for WLS.

I also decided on the Vertical Sleeve. BCN covers it only if you have a BMI of over 50 (I'm at 57 I believe), and they also waive the 6mth supervised diet if you are a BMI of over 50.

I thought I needed to get my PCP to give me a referral to go to a Weight Loss Surgeon, but I didn't. The first step was to call the Surgeon and go to their Orientation. After the Orientation they called me and set up an appt for the Physical/Medical History. I have to pay $50 for that appt..as well as my $10 co-pay.

Even though my BCN policy states it covers WLS 100%, it doesn't cover everything. My out of pocket costs will be about $1,000.

I just wasted $10 (my co-pay) today as well. I thought I needed to go to my PCP to get a referrel for the Psych. Evaluation. I don't. I just had to call the Mental Health number on the back of my BCN card and they told me what doc in my area to go see.

So, so far I haven't needed my PCP to be involved in the process..as of yet.

Hope some of this helps..

Dawn

I had surgery downtown @ Henry Ford main as well!! Loved it & doing well. However I am a RN @ Henry Ford Wyandotte Hospital & as of Jan 1st we got our certificate for being a center of excellence as well. And w/ our surgeon Dr. Steven Hendrick there is not much of a waiting time and he takes BCN, not sure how much he is involved w/ doing the sleeve though. But its worth Checking into!! Good Luck!