blue cross and blue shield

hi i just went for my consultation yesturday so i still need to do all the pretesting and what not. but i was wondering what peoples expereicnes were with bcbs covering the surgury. i have the ppo plan the doctor i am using is out of network. but i am worried if the surgury will be covered or not. they have told me i need to prove 5 yrs of medical diets and such but i dont really have that most diets i did were personal with a gym etc. any advice would be appreciated.

I have horizon BC/BS HMO and they covered my surgey in full and they approved me in 2 days. GOOD LUCK !!!! Laura

Rose Marie, I had BCBS and they were great. I beleive what they want is 5 years of weight records. (one medical document for each year with your weight listed.) Then they want to see what attempts you have made to lose weight with in that time. If u were on anything else within that time, get the records and submit them also. (Jenny Craig, tops, weigh****chers etc....) They will also want an attempt with in the last 2 years that lasted 6 months. I wasn't sure they would accept my last attempt, because some of it was documented through TOPS, but they did. When I heard all of this stuff they wanted, I immediately started another diet with my doctor. Just in case they didn't accept it, I had a few months under my belt alreday. I also wrote them a personal letter pleading my case. I explained everything that I had been on over the years and why I think with this tool I will be able to do it now. IE, I have better excercise habits, drink my water, take my vitamins. I could just NEVER feel full. Good luck to u!!!!!!!!! Kamma

I have the PPO BCBS no problems so far my doc and pre-op is covered (all in network). I don't think they will cover out of network... but you could ask Good Luck! Phil

OMT... Dr Nusbaum was my first choice but they told me they would not take me becuse of BCBS... Now I'm looking at Dr Schmidt (or BCBS has his partiner Amit Trivedi listed) who BCBS highly recomends. -phil

I too have BCBS HMO, and all of the costs were covered, and approved in less than one week. Only needed the medical necessity letter from my PCP. Good luck! You should have no problem.