Who can tell me about BCN and WLS?

Done with HAP, what a waste of the last four months. Got the news today that my department is being outsourced. Im still going to have a job with the new company, but my current benefits run out May 31 and my grievance hearing hasn't even been scheduled yet, so there is no point in me pursuing WLS with HAP any longer. Unfortunately, the new insurance through the new company isn't any better. Its Blue Care Network. Anyone that can tell me about BCNs requirements?

Be very sure to contact them regarding what your policy states regarding WLS before you proceed any further. My husbands BCBS went into effect 12/25/05 (at his 90 days) and they told Liv-Lite that if I had any weight loss surgery attempts before that date that I would have to wait one year before they would even consider an approval for surgery. Sorry if this may be bad news, but it saves from having to go through everything just to find out you have to wait longer. Michelle

Are you referring to a pre-existing waiting period of a year? If so, that wouldn't apply to her since she sounds like she has had continuous health insurance. Pre-e only applies if you had more than a 63 day lapse in coverage. As for your husband's policy...if you had one year continuous health insurance prior to your effective date with BCBS...get a certificate of credible coverage (a letter showing the eff/term date) from your previous insurance carrier, and have him give it to his employer to have the pre-existing time period waived! Even if you had more than a 63 day lapse, you might be subject to part of the pre-e time period, but maybe not all of it. Any questions, call customer service at BCBS and they should be able to explain it and tell you exactly what to do based on your particular policy/company.

Actually, we had my insurance and his insurance for 6 days (too much of a pain to cancel mine for 6 days). So therefore, we did have continuous coverage. BCBS of Texas did state that our specific policy says I would have to wait until 12/25/06 if I had any WLS attempts within the previous year. I just wanted to let Colleen know to cover all her bases and be sure their particular policy did/did not have that exclusion. Michelle

Call Paula, the program director at St Mary Mercy Hospital. Call her immediately! 734 655 4218 Ok, wait till the office opens. She is a wizard with insurance companies and has my BCBS aproval with even less documentation (I think) than what you can provide. Do you have copies of all your records? That will help her immensely. Dr. Zeni is the surgeon and everyone seems happy with him (me too, so far). He has been very forthcoming and very available, I'll be able to offer more of an opinion after May 31, my surgery date. You have been working so hard at this, don't quit now! Best wishes