Any OK teachers with Community Care HMO?

I am just starting the process of trying to have WLS, and am also in the process of changing from Healthchoice insurance to Community Care HMO (Jan 1). Reading the postings about the different insurance companies, it looks like Community Care is about 50/50 so far as approvals go--and that employers can opt for different packages. Is there anyone else out there who teaches or works for a public school system and has CCHMO? If so, I'd love to hear about your individual experiences dealing with the insurance issues.

Hi Pam, I am a teacher and I have been working on this process since January and I am with PacifiCare HMO. I was denied once, appealed, and found out today they denied me bc it isn't a covered surgery. Well I am still fighting... I have proof (PacifiCare) they have paid for other PacifiCare patients surgery and I have a lot of medical reasons for the surgery... Long story. I just wanted you to know I am fighting for this. If I can help let me know. Kathy

Good luck with the insurance company Kathy. I'm still waiting for my new membership card to arrive so I can log onto Community Care's website to see if it's a covered surgery with them (if my school district opted for the coverage). Keep fighting!

Thanks Pam. Good luck with Community Care. You might see if you can contact any of the others who have CC through the Oklahoma Insurance link on here and see if anyone has had the surgery this year. What I am finding out is that it isn't up to the school district to decide if it is covered with the HMO. Health Choice is different though. It is up to the HMO. That is the answer I got from the insurance board this morning. I hope I am not leading you down the wrong path. Let me know if I can help you in any way.