Empire Blue and General Dynamics?

lapband4e
on 10/9/07 11:52 pm - MD
Does anyone work for General Dynamics or has Empire BCBS for insurance and has or has not approved? I greatly appreciate any infroamtion you might have. I have already called thme and they said it is approved if medically necessary, but they don't define medically necessary., I have also gone on their website and checked the guidelines, but the latest is as of Summmer 2006 and I am not sure if th reason that they haven't mentioned anything in the new guidelkines released after Summer 06 means they still go by that guideline or they have changed policy. I am insured through DH and if I don't get covered the only option is to get insurance with my own company that has (Carefirst BBCBS) and I am not sure if they approve or not since I have read in the posts tht with Carefirst so many employers exclude this surgery. Thanks for any info Clueless Ellie
TynettaM
on 10/10/07 1:23 pm - Greensboro, NC
I have empire blue. Medically necessary means that you doctor surgeon is ok with you having it and can prove that you need it. I had to have a 5 year weight history provided by my PCP, psy consult, nutritional consult, and pre op education and consult. Check out this site for the forms you will need in addition to the info above to give oyu a fighting chance, but also talk with your surgeon and coordinator. they are your best sources. I came out lucky, b/c people I know had to have all sorts of tests. http://www.empireblue.com/medicalpolicies/policies/mp_pw_a053317.htm, print this...it has the full policy and a form for you surgeon to complete with your other documents
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