BCBS

I am new to this and havent even been to a doctor as of yet.....i have bcbs ppo and was wondering what that policy said about the lap band procedure...anyone know???...im in texas if that makes a difference..

HI!  I found some links for you for your insurance.  I hope this is helpful.   http://www.bcbstx.com/member/obesity_management/om_centers.h tm http://www.bcbstx.com/member/obesity_management/om_medical_p olicy.htm Leslie J

Hello, I have BCBS Community Blue PPO. They don't require prior approval, but they do require a letter from your PCP stating that you've made several dieting attempts in the last 4 years as well as other things. It's all in the wording. Where are you wanting to go for surgery? I went to Barix, they had a sample letter for my doctor to copy exactly word for word, they did everything else. I was having surgery just under 2 months after consultation! :) Good luck hun, Cynthia

Hello and good luck on getting approved. I had Anthem Blue Access PPO which is also BCBS. Under that plan I was not covered for the wls. A friend of mines told me to call the place where I want to have my procedure and ask for the billing codes and then call the insurance company back and ask if they would cover those codes. Unfortunately they said no. However, I called back and asked if the employer offered a different plan and if the surgery was covered under that plan. Great news there the HMO plan covered it. Just get those codes and call they will tell you if they cover wls. If not ask about a different plan they may have available. Good Luck!!

I have Blue Cross of California PPO and had no problems with getting approved for rny. I originally started considering the lap band, but then changed my mind. I'm glad I did too, because when I went in the office to schedule my surgery there was a posting that said that Blue Cross isn't going to cover lap band adjustments. The only things I needed for approval, was my complete life history, including family history, diets/exercise I've done, fasting blood test, chest xray, seminar, and psych eval. The day I went in for my consultation they told me that Blue Cross also needed a letter from the pcp, and a visit to the nutritionist, which I actually scheduled both of those appointments, and found out I was approved before they even happened, so I cancelled them. But that's not to say they still don't require the information now, just not from me. I would call your insurance company and ask them what's required, I did that and they directed me to an internal website that listed everything I needed to know.