Empire Blue Cross and Blue shield Insurance

My husband is fixing to sign up for new insurance for us with Empire Blue Cross Blue Shield out of NY. Does anyone know anything about this insurance covering Bariatric surgeries? Appreciate your help! Cathy S.

I don't know about empire bcbs. I would call and ask them if they covered gb. I have bcbs and I was approved 3hours after they received my paper work. But I do know that I have read about people that did not get approved from different bcbs's so go out on a limb and call them or check with your husbands human resource dept. Sometimes the company will ask for an exclusion. I tried to have a gb 3 years ago and my husbands company had a huge exclusion in there policy. The dr's office I was going to then said it was the most strict exclusion they had ever seen. So investigate it before he signs on the dotted line. Good luck. Tammy

Cathy, My husband works for PGB and we have Empire Blue BCBS and it covered my surgery as well as all the pre-op visits except for the psyc evaluation. I had to pay my co-pays and deductable which was $1500.00. I got approval in 48 hours and they have done monthly follow up calls to check on my progress. I couldn't have asked for anyone easier to deal with. Shannon

I have Empire BCBS and for the most part they were very easy to deal with. Just make sure that as soon as he switches to this insurance that he starts documenting with his doctor at least once a month weigh ins. I was 6 months into the process when they told me that I needed 6 month of dr supervised weight loss cks and discussions about alternative choices besides surgery. ANy questions feel free to email me... Noelle

Hi, I have Empire BCBS and was approved within 2 hours of paperwork being submitted. You just need to make sure that your doctors office has all the necessary paperwork in order and like the one girl replied, make sure you do have the 6 months documentation of trying to lose weight. They were always pleasant over the phone. Good Luck!!

Just in case your wondering. I am the one who wants the surgery. I did get this from someone on the NY forum... http://www.empireblue.com/provider/noapplication/f2/s5/t9/pw_ad080419.pdf It was real helpful. It doesn't say anything about 6 months weight program but it does say that the patient must have actively participated in non-surgical methods of weight reduction; and these efforts must be fully appraised by the physician requesting authorization for the surgery. I am assuming that if I show proof that I lost weight on Nutri-system for 6 months and gained it back and then I worked with a nurtritionist for 5 months and took Iononamin and lost alot of weight and later gained it back that hopefully this will be enough. I've done the wonderful weigh****chers many times but I don't have documentation of my loss and not sure if I can get it. I also have degenerative disease in my lumbar back area and hypertention. I'm being tested for sleep apnea in Jan. I have a bmi of about 39 right now. With this information do you think I could get approved????????? Thanks again for your help!

Hey Cathy, I have BCBS of South Carolina and I am having the hardest time with them getting approved, I had all my tests and appointments all done in Oct and sent them 4 doctors letters telling them this was medically necessary plus 2 yrs of weights watchers, that my docotors had to state because weigh****chers doesnt keep any of your information once you stop going, I was told they only keep life time members info, which I think is so unfair when your trying to get as much documentation for the insurance co as possible. I was told by my surgerons office that they had called back and wanted supervised diet for THIS YEAR and I had to get it to them by Nov 24th. Well I had gone to my pcp on the 3rd of Nov and he wrote me a letter stating I was in weigh****chers this year so on and so on, well I went to fax the letter and also some print outs of medications I have been on from 2003 to 2006 but when I called the surgeons office to let them know I was faxing it they told me not to bother because BCBS had already denied me on Nov 2nd. I was so upset with them I couldnt think straight. Now Im at the stage of appeals and hoping they approve me this time. Its such a hassel getting them to help you its not even funny. You pay and pay for insurance only for them to deny you what they know for a fact its something you need. Well I wish you much luck and hope you get to have your sugery soon. Denise

It will be up to the company he works for to have elected the benefit.

Hi Cathy, I don't have "Empire" BCBS, but I do have BCBS out of Western NY and I didn't have any trouble getting approval...just had a ton of hoops to jump through first. I'll cross my fingers that things go as smoothly for you. Take care! Lisa