Oregon Teamsters BC/BS

Jen,  that makes more since, but if you have already had gastric bypass why would you need to have this changed now?  Julia

For follow-up care purposes only. . . Labs, etc. Or  worse case scenario, any complications causing hospitalization. I'm doing fine, so don't expect problems, but JUST IN CASE... wanted to know what my new insurance covered.

Hi Jen, I actually work for BCBS and I work directly with the Oregon Teamster contracts.  What the rep told you when you called is correct.  The contract actually states, "Only the surgical treatment of Morbid Obesity is eligible on the Oregon Teamster Employers Trust Plan."  Which means the things that are required before surgery are not covered. Like the visits to the nutritionist and counselors. I know you said you have already had your surgery, so that part wouldn't matter.  But it also states,"Routine surgical follow-up associated with approved bariatric surgery procedures are allowable,"  So by you having your surgery in Mexico, it is really unclear if your Oregon Teamster plan will cover any needed follow up surgery or not because we did not cover your bariatric surgery to begin with.  I would suggest if you need to have anything like that done, you have your doctors pre authorize it.  Regarding the labs, you may want to call and talk with the Nurse Case Manager for Oregon Teamsters.  She is the person who handles a lot of the Bariatric questions.  Her name is Suzy Fong. You can call the number on the back of your card and ask the customer service dept to speak with Suzy. Let them know you have specific questions about what services would and would not be covered in referrance to your post bariatric surgery that you did not have paid through your current insurance.  They should transfer you with no problems.  There are a lot of different criterias that have to be met and/or documented for different procedures.  Like the "Medical Necessity" factor and specific contract exclusions on your plan. I hope this helps.  Good Luck! Sarah

Sarah... Wooo Hoooo! You gave me the information I was looking for. WOW, I am so lucky that you found my post on here. Yeah, my main concern are labs. I recently found out how spendy they are and if the insurance covers them, it will help me out alot and I'll probably be much better about going in for my routine labs as needed. I don't have a card yet. I turned in all the needed documents in early Feb... still nothing sent to me. This is why I turned to OH members to see if anyone here had any experience/knowledge with Oregon Teamsters. "approved bariatric surgery procedures" sounds to me that the company will only approve certain types, such as banding or usually RNY. Many insurance companies specify a specific procedure they will allow, so this is my interpretation of this statement. Once again, Thanks so MUCH for your help. You are an angel. Jen in Vancouver WA

Jen, You are totally correct.  The teamster contract states, "Gastric Bypass (Roux-en-Y) and Adjustable Gastric Banding (Lap-Band) are the only eligible surgical procedures"    The phone number to call your Teamster Customer Service is: 1-800-452-8812.  If you don't have your id # yet, they CAN look you up by name and date of birth.  :)  Have a wonderful day! Sarah