Anyone with BCBA of Massachusetts

I was just curious if anyone has bcbs of mass. for insurance..I talked to them 2 weeks ago.they said surgery is covered i only have to pay 250.00 there are some criterias to meet. 1. Mordbid Obersity bmi 40 or 35 w/ co-morbib conditions. 2. attempts at weight loss have failed. 3. obesity has persisted for atleast 5 years. 4 no untreated metabolic cause for obesity such as thyroid disorder. 5.. patient must be a adult.. My only concern is the physican im going to now as only treated me for 2 years..any help would be greatly in debt.... thanks polly

I have the same insurance and I didn't have to pay one red cent... I guess it depends on your plan. I never even talked to them once, my doctors office did everything. I had a new doctor as well but they should have your chart and if they don't you can sign a release and your old doctors will send them.... The only problem I am having now is getting reimbursed from short term disability. Health insurance was the easy part! Good Luck!

Hi Polly-I have the BC of Mass--My Docs office only had to do the referral in the computer system. Never had to write a letter as many folks write here about. My surgeon wrote the letter of Medical necessity. When I went to the surgeon-I did have to complete a medical questionnaire form that listed your diet attempts-I put since I was 18 years old. And--I've only had this particular Blue Cross for 2 years. So--no one actually verified that I had been obese for 5 years. Maybe my signature on the medical questionnaire is what they use for the trust factor. My doctor's assistant (Eileen) is a wiz at this insurance stuff and she told me from the get go that BC was great to deal with. She was right. I hope this puts you at comfort, Polly Joan F.

Hi Polly, I have BCBS of Mass (HMO Blue) and my PCP wrote the letter saying basically how long I have been obese, weight loss attempts have failed, and my diabetes. I got a referral to the surgeon and his office sent in my PCP letter, my psych eval and nutritionist eval and got the surgery approval. Why do you have to pay $250? That sounds like an outpatient copay - does your surgeon do this outpatient? I had it done inpatient and paid nothing. Another thing, BCBS only took 3 days to render decision - that's a big plus! P.S. It doesn't matter how long you have been seeing your current PCP - he/she should have a complete medical history on you and can provide that to insurance.

I agree with everyone else! BCBS MA was great! I didn't pay a cent except the co-pays for some of the pre-op visits and the psych testing (not usually covered by any insurance). I had my letter from them before I heard from my surgeon's office with a date and from they time the sent it in to scheduling was about a week. I believe any attempts at weight loss count for those 5 years so try to remember dates and numbers of times you tried programs such as Weigh****chers, Jenny Craig, etc. The further back you can give dates, the better off. Good luck! Luann LapRNY 9/14/04 -76lbs

Hi Polly, BCBS approved me for the surgery. I have not been treated by a dr. for obesity for 5 years, but I've been overweight my entire life. I think they go by "your word" and not how long you've been seeing the dr.. Good Luck~ Lynn