BCBS of Rochester NY?
i live in mass and my husbands company has bcbs of rochester ny. i have called them to ask if they cover the surgery and they said they do but then ive been hearing all sorts of things about how since its an out of state bcbs they probably wont cover it. we have a ppo and pay a lot of money for it so i would assume it would be covered... any insight? has anyone gone through this with bcbs?
Because you live in one state and having BCBS in another state does and should not matter. If your product is a PPO product and national account they Blue Card between states. You just have to follow their network guidelines. etc. I fyou need further questions answered. Do not hesitate to PM me I will assist anyway I can with questions and answers
thanks for the insight and help. i just called my insurance company and they said that out of state doesnt really matter and for me not to worry about that, it will go as regular bcbs ppo. however she said there was a HUGE book she will mail out to me and 8 major regulations. she read them off to me, but as sweet as she was she was honest in telling me she didnt know much about what they meant and i will have to talk to my dr and when they send in the letter for approval we will find out then. they were normal criteria like -bmi over 40, or bmi over 35 with co morbities (im pretty sure im over 40...) -5 year duration of being over weight (i wrote this on my memo to my dr before the first appointment over a year ago, im not sure what proof they need, pictures?!) -no kidney or GI problems (i had my gallbladder out in 2006... i dont consider this a problem anymore... should i?) and then there was this one -1 or more rigorous attempts at weight loss equaling 6 months. now is this the 6 month pcp required diet everyones talking about needing for aetna? or is this having to do with the sheet i filled out letting them know what ive done in the past ie: weigh****chers, diet workshop, the gym, gall bladder surgery. etc.
also they said it depended on the type of surgery, rny, ds, vbg, and im sorry for sounding ignorant but i thought there was either lap band or gastric bypass (either open or laproscopically) any insight as to what these others are?
thanks again for all the help, i feel so stupid even though ive been trying to read up for a year i guess i didnt read enough?!?!
also they said it depended on the type of surgery, rny, ds, vbg, and im sorry for sounding ignorant but i thought there was either lap band or gastric bypass (either open or laproscopically) any insight as to what these others are?
thanks again for all the help, i feel so stupid even though ive been trying to read up for a year i guess i didnt read enough?!?!