AR BCBS vs. Anthem BCBS. Help?

I seriously detest dealing with insurance.   I have AR BCBS. It pays 50% up to $4000. Big woop. My husband has Anthem BCBS (covered since June 09). I've registered him on the website but can't find the blasted benefit section. I know they bury them deep on purpose but dang! So - anyone know how to access benefits on myanthem.com? Anyone know what WLS benefits are for Anthem BCBS? Their customer service is M-F only, of course. :p  Since I'll be out of pocket $12k+ with my insurance, I'm thinking about waiting until open enrollment comes around and getting on my husband's insurance, assuming it pays anything more than $4k. Thanks so much for any and all help!

Charlee

My dad has BCBS Anthem and I have full coverage. My out of pocket is $2900 for a $26,000 surgery. I'm not quite sure where to access the benefits section on their website. My sugeon's office advised me to call the # on the back of the card and give them the ICD9 codes to see what they would cover.

Full coverage would be awesome! I called today and was told you can't access benefits on the web - even though the website says you can. Go figure. They're mailing the actual benefit packet to us. I will get codes and call them again. Thanks!

Hi,

I am going through some what simular situation.

I have Personal Care as Primary (HMO)...and secondary BCBSIL PPO.

HMO wants me to complete 12 month diet and PPO now only requires 3 months.

The dr and hospital are both in network....but I want to have surgery ASAP.

So I am thinking about dropping my primary..and make BCBSIL my Primary

Hi Datrace,

I have a bit more info now. My husband's insurance, Anthem BCBS, does not have an exclusion for WLS and does cover the DS and the RnY the same as any other surgery. I still don't have the benefit info for his policy, so am impatiently waiting on that. Looks like I'm not having surgery anytime soon, which is a huge disappointment but I'm trying to use the time between now and then to get some other ducks in a row. It'll happen when it happens. meh. Good luck with yours!

Charlee

Hello Charlee,

Good luck with everything.  It can be stressfull.  I have BCBS Anthem.  I too was having a hard time finding anything on the website.  I called and they promptly sent me out the clinical guidlines.  I am in NC.  I am so excited to find out that I do not need the 5 year documentation stating that I have been obese.  I have worked for a Doctor for the last five years so have got what I needed from him and therfore do not have any documentation as to my weight history.  With Anthem, you must have a BMI of 40 or a BMI of 35 or greater with co-morbid conditions, and must have actively participated in non-surgical methods of weight reducion.  Well that part was easy, since I have tried every diet under the sun.  My last endevor was LA weight loss.  With Anthem, I also did not have to have the 6 months Doctor supervised weightloss attemp that so many other insurances require.  I have a $450.00 deductible to meet and my plan happens to be an 80/20 plan but I have a max out of pocket of 3,000.  The Surgeon's office said they will let me make payments on that 3,000. 
I have attended the initial seminar, now I am waiting for the office to call me for my initail appointment, then I go from there.  Anthem does require all the usual, psych eval, pre-op and post op dietary eval and nurtitional counseling etc.  Go for it Girl.  Find a surgeon, attend the free seminar and go from there.  They will also get all your insurance info from you and let you know what all you need and will help you in that process.  Good luck with everything.

Im am just starting this process and I have Anthem BC/BS it will go in effect on october 10, 2009. I have attended the seminar and have had my consultation with the doctor. I meet the BMI requirements and other conditions required to have the surgery. All I have left to do is the psych evaluation and dietician. How far have you gotten and do you know how long it takes to get an approval? 

hello my name is robin!
 i have no insurance and i was thinking about getting the bcbs in new hampshire but i just wanted to know how long i should wait to send them a letter for my approval?
and do all the bcbs plans cover the lap band?  i am 5'4 and 256lbs and i am 30 yrs old and i have venous stasis and cronic lmphedema in my legs! pleas help