Empire BC/BS HMO

Does anyone have this insurance? I am looking for any information anyone could give me on their experiences. Anything I should look forward to or should know about. My surgeon's office takes care of everything with the ins and says that I should have no problems, I'm just nervous that something will go wrong! Thanks, Andi

Andi - I have Empire BC/BS PPO, and my paperwork is being submitted to them this week by my surgeon's office, so I should be able to tell you in a little while whether it went well or not. I would think I'm a tough case to approve, too, since my BMI is just over 40 but I don't have any significant co-morbitities (yet, anyway....that's what I'm trying to prevent!!). I'll come back and let you know how it goes with them. My office also says that they think it'll go through, but I'm with you....until I hear that golden word (approved!) I'm still nervous as the dickens that they'll turn me down! Good luck to you! Alison

Thanks so much for your reply. It's nice to know that I'm going thru this with actual ppl! Keep me posted, please! Thanks again, Andi

Alison: I also have this insurance, I am one week post op (phew!). I had a BMI of 41, (Not anymore) and one co-morbidity (mild hypertension) and had no problem at all with getting approval. Hope the same for you. Jane

Hello Andi,I have Empire BC/BS HMO,I am not sure if mine is the same as yours. I guess it depends on what your employer has included in their specific policy. I have had no problems whatsoever with getting approval for the WLS. I just had to make sure I had all my appointments made with in network doctors and then get the proper referrals. I called them myself to ask what their requirements were for the WLS so that gave me a heads-up. The only thing I can remember now is getting a few bills for some of the tests that were done,I then called them and they took care of it saying that it sometimes takes time for BC/BS to get the bills and the Dr.'s offices may send out bills and they may cross in the mail(long winded-sorry!)It is just a long process which is a good thing really,it gives you time to be absolutely sure about what you are doing. I hope I helped in some way--Robin

Thanks for your info. They told me just to make sure I have the appropriate referrals and submit everything requested. I'm sure there's not going to be any problems, but still, you always wonder! Andi

I have the direct HMO. They paid for everything, right down to the psych eval (I had a $25 copay). I had a couple of $10 copays, but the total was less than $100. I had surgery in March and, so far, I have had nothing to pay. I called the hospital ahead of time to make sure they accepted whatever the insurance paid. My approval was given within a few days of submission. My surgeon's office was specific about what I needed to have ahead of time. It also helped that I had a high BMI and a couple of comorbidities. Good luck, I hope it all goes well for you. Cheryl

Thanks Cheryl! That makes me feel much more at ease, but as the poster said above, I won't be completely at ease until I hear those two magic words, "You're approved!" Have a great day, Andi

I do! was aproved first atempt, no problems at all. Just make sure you have aBMI over 40 and have a detailed diet history. Good Luck. Jane

Thanks Jane! I actually called Empire yesterday and the rep told me I should have no problems getting approved as long as the doctor sent in all paperwork required. She said as far as my diet history, just to give a detailed letter of the diets I have tried in the past and failed at. Doesn't have to be dr. supervised or even have specific weight loss/gain listed! WOOHOO!!! Andi