bc/bs state health

JENNIFER B.
on 6/28/05 1:00 am - THOMSON, GA
I called my insurance company yesterday and ask about the requirments for the surgery.They said they pay for it but,after July st they will no longer pay.Are all insurance companies doing this?
(deactivated member)
on 6/29/05 1:48 am - Alameda, CA
I am afraid this may be true. I received the same type of news the other day from my WLS center. I was not ready to submit my paperwork yet-I had about 8 more classes to go and 20 lbs to lose-and they they let me know they are pushing my paperwork through this week because of the July 1st issue. Does anyone have a link or a document that outlines this specific change for BCBS? Thanks! Lacyanna
JENNIFER B.
on 6/30/05 1:44 am - THOMSON, GA
THAT SUCKS.I AM GOING TO CHANGE INSURANCE COMPANIES IN OCT. BUT THEN IT WILL BE JANUARY BEFORE IT WILL COME INTO AFFECT.I'M GOING TO CHANGE TO CIGNA HEALTHCARE.
hessie28
on 6/30/05 10:04 am
I have Horizon State Health Benefits. I was denied for my revision but I am appealing. Hopefully the July1st won't apply to an appeal. I think if you appeal there is always a chance.
JENNIFER B.
on 6/30/05 8:15 pm - THOMSON, GA
CAN I APPEAL TO THE INS.COMP.IF I HAVEN'T EVEN STARTED A CLAIM.THE INSURANCE COMP. JUST SAID AS JULY1ST THEY WOULD NO LONGER PAY AT ALL.
hessie28
on 7/1/05 11:43 am
I would see your surgeon and let them submit the paperwork. Once denied you would then appeal. I think there are ways around everything. If the surgeon says it is medically necessary you may be okay. I would have your primary send a letter and get all documentions on any medical conditions. Bombard them with reasons why you need the surgery. Good luck with everything.
hessie28
on 7/1/05 11:48 am
Oh, I filed a formal complaint with the Insurance and Banking Commission of New Jersey about the denial. It has been about 2 weeks so have not heard anything yet. If you are in NJ you could also do that.
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