Insurance Advice

So three years and 30 pounds later I am going to go ahead and try to have surgery. I just started a new job and am trying to pick my insurance. Of course I want the one with the most likelyhood of getting approved. I have read through the entire link oninsurances and they all seem 50/50 and most of the posts are from 2001. Can anyone help steer me in the right direction. I can choose from: Cigna (Choice) Blue Cross/Blue Shield (HMO) Kaiser (HMO) Thanks! Beth

Hi, Beth. My wife and I have BCBS (HMO). We had to jump through a lot of hoops with them before we both were approved. (Actually my wife was approved in 1 week, once all the paperwork was completed. For me it took about a month.) We talked with the nurses at our doctor's office a week or so ago to find out the latest with BCBS's position on WLS. She said that after July 1st, they would only approve the surgery under certain cir****tances (which BCBS would not reveal) and that you would have to use a specially certified group of doctors. They also said that coverage will depend on whether or not your employer wants to have WLS added to the policy/plan they choose. I think they called it a "Rider" or something like that. So, I would suggest you talk with your HR person at your new job and see which insurer will cover it. Good luck in your pursuit. My wife and I are so glad that we both had WLS. We only regret that we didn't do it sooner. And, this way we know we will be around a lot longer for our children. I hope this information helps. Our doctor is on Gainesville. If you'd like to check out their website, it is www.obesitysolutions.com.

Hey everyone, thanks for responding to Beth. She's my best friend, and was with me at the monthly lun*****ennesaw at Joe's Crab Shack a couple of months ago. She's trying to get her ducks in a row, and I appreciate any and all advice the "pros" can give her! Kelle

I had BCBS of Georgia. I don't know if anything has changed, but I had very little difficulty once all info was submitted. GOOD LUCK!!!

Hi I was just reading your post about having BCBS of GA, and how you didn't have a whole lot of trouble getting them to approve. I wanted to know if that approval was before Jan 1, 2005? I have BCBS carefirst it's out to the Maryland/DC metro area and i was told that BCBS would no longer cover WLS after 1/1/05. Help or advice greatly appreciated.

Hi Connie, I have heard such as that, but no, I got my approval in May of 2004. You will need to contact your carrier and see what their requirements and/or exclusions are. Wish I had more info to share with you. GOOD LUCK!! Tami

Hi Beth Make sure you call each one and ask if they cover it, as some will be excluding this surgery soon. I work for fulton county and have been told that after july 1 that state health benifit will no longer cover this surgery. Also ask each one what their rquirements are, that way you can be more prepared. Good luck in your journey. Tina N

Well it looks like Cigna is my only choice. Kaiser told me flat out they did not approve any "cosmetic surgery" and everything I have seen for BCBS is that after July 1st they are not covering it. Cigna (talked to a wonderfully nice woman) say they do cover it with the approval process. Talked to my work and they cover it as long as the insurance deems it medically necessary. The guy I talked to on my benefits line was a riot, he was floored that people would not consider the surgery medically necessary. So back on the phone tomorrow to Cigna to find out specifics. Hiho Hiho, what a long road to hoe. Thank you all for your assistance!! Beth

I'M HAVING A HARD TIME WITH BCBS OF GA THEY SAID AT FIRST THAT THEY DO PAY FOR IT AND NOW THEY ARE SAYING THAT THEY DON'T SO I'M WAITING ON AN ANSWER. THE DR OFFICE FAX MY INFORMATION IN LAST WENDESDAY SO I'M JUST WAITING

Hi Beth, As for one who has a little knowledge in insurance and those needing help with wls.... Stay away from Kaiser, They do not cover it, period. As for the other two, I would pick BC/BS (HMO) they would be more apt to pay for it before Cigna. Cigna now requires one to have the most documentation showing a lot of B.S. to have the surgery. Let me knnow if I can you in any other way. Crece