Insurance Question

Has any been approved with Capitol BCBS PPO northeast Pennsylvania region, if so how was the work up or any requirements?

I recommend pulling out your policy booklet or looking up the guidelines online. Many insurance companies now require a six-month supervised diet. Pre-op testing will depend on your health history, but often a sleep study will be ordered.

Yes, I did that today. Thank you for that helpful piece of information. I actually got an appointment to go in and see my PCP to talk things over and have her write a referral for the surgery.

Good luck! We're pulling for you.

I am not with that provider, but understand that there can be 500 different PPO plans for one provider - some are particular to the employer. Your best bet for accurate information is to call the number on the back of your card and speak with one of the representatives. Or do a search on the member portal as that will link you to your own plan documents.

As I work with insurances on a daily basis, the best advice anyone can give you is the call the benefits number on the back of your card and ASK specifically what their requirement is for the pre-op and post-op care of the surgery. Also, talk to your family doctor. They MAY know what is required for your insurance, or they may be willing to do the legwork involved in finding out that information.

On another note, since you are somewhat close to where I am, see if the Lehigh Valley Hospital Bariatric program (610-402-5000) is allowed on your list. They have wonderful classes and will help you on your journey.

Good luck!

Family doctors' offices usually have no idea of plan requirements, since they will have to refer to a specialist.

Chiming in with all the other advice that you need to call the number on the back of your insurance card and ask!

I suspect that the bariatric surgeon you consult with should be more than familiar with the requirements of most major insurance carriers in their local area. Most have surgical/insurance coordinators who can let you know what is required for approval.

Hope this helps and good luck to you.