Going from atena to premera bluecross by employer

Johanna V.
on 8/17/09 4:24 am - New York, NY
Ok so my employer is switching from atena to premera bluecross. I am still going through my 6months of deiting stage..for the insurance...my pcp is willing to approve me but because of atena i have to diet consistently for 6months starting now in august. Does anyone have advice for me about premera bluecross is it the same for the approval process?? I want to get approved soon or atleast before spring school semester starts in the end of jan 2010..help!!
Just M.
on 8/17/09 11:12 am
when does your plan change? if not till January then I would do the 3 month diet for aetna...
aetna has 2 physician monitored diet requirements you can do the 3month (90 days =4 visits to doctor. or 6month (180 days= 7 visits to pcp). Why did you choose the 6month? especially if your insurance is changing. the only thing with the 3month it has to be multi-disciplinary. where you go to pcp, see a dietician or nutrionist, have a psych eval, incorporate behavior modification, and see the surgeon at the beginning of monitored diet and 1 time at the end of the diet. I would try this if I were you. Just a suggestion pm me if you any more questions. i can send you info I got from aetna and from my surgeon's site she has a wealth of info to help you.
Either way you choose Much Much success to you.

Tenisha
Dsquared
on 9/5/09 9:37 pm, edited 9/5/09 9:38 pm - Buffalo, NY
ScaleLie, I wonder if we work for the same company (does it involve wearing green? LOL).  I am also trying to get my surgery during winter break from school, but I haven't done anything but pick my surgeon because of the insurance change. I don't know what Premera covers at all, because they haven't sent us our information packets yet.  I wish they would hurry up!
Johanna V.
on 9/5/09 10:13 pm - New York, NY
yes it does!!! yeah im still trying to diet through doctor monitored (6months)...yes i hope they would hurry up too.. i beileve it starts Oct.1...for the switch...smh...good luck..keep me posed!!
Dsquared
on 9/5/09 10:33 pm - Buffalo, NY
Oh, yay!  A Barista-in-Arms!  So you know the special challenges of working around all that whip cream and coffee cake!  Do you know how much Premera covers for WLS?  I opted to bump my coverage up this time around and am on the top tier, so hopefully it will cover most of it.  Are you getting LP or GP?
Johanna V.
on 9/6/09 5:53 am - New York, NY
Yes....i have been avoiding all that stuff..ill eat the oatmeal, banana, Vivanno with skim and turkey and swiss sandwich(without the swiss)..the healthier stuff. Got to lose some kind of weight...I put the foods in my mouth noone else...so trying to get that in control it deff. is veryyy hard...all those pastires are tempting. I know atena covers 80 percent and the hospital will usually help you find a way to get it all covered through the insurance...well thats what the Finacial mgr at my WLS hospital told me. But i know they cover 80percent for sure!! I want to get the lapband if i get approved...sept 18 i have to go back to the pcp...ill be makingmy 1st month out of 6...idk what lp or gp mean?? so i cant tell u that..lol
Dsquared
on 9/6/09 6:04 am - Buffalo, NY
Oh, haha, I meant LB or GP - Lap-band or gastric bypass.  I had no idea Aetna covered it at 80%.  All this time I thought they didn't cover it at all!  Oh well - just a few more weeks until Premera anyway.
nellynel_1379
on 10/20/09 6:50 am
I'm in the same boat. My coverage starts Nov 1 and i'm impatient! I want to know exactly what the pre requisites are so i can get the ball rolling.... Blue Cross said they cover 80% i think, but they cant tell me for sure until I am OFFICIALLY in the system. UGH!  I'm so close and I am starting to get a little disilluisioned.  As soon as anyone gets any info , can u please let me know? Thanks
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