QUESTION about Vertcal Sleeve and ANTHEM BC/BS in OHIO

dmike98
on 10/12/09 1:32 pm - OH
I am new to this forum and I am in the first stages of the Vertical sleeve procedure. My question is about insurance. I live in OHIO. I have ANTHEM BC/BS and in my policy it still lists the Sleeve Gatrectomy as experimental. Has anybody on this forum had this procedure with ANTHEM as a provider and if so how did you go about getting them to approve it. Keep in mind that I have not been denied as of yet because I just had my first appointment last Friday and am still in the beginning stages. I was just going over my policy this weekend and was starting to get concerned.
    
Robin W.
on 10/13/09 12:35 am - Franklin, OH
It sound cut and dry that according to your policy they will not approve the Sleeve if that is what your policy states. You should call your insurance and see if there have been any changes to the policy and how do YOU and you DOC go about getting the sleeve approved if that is what you really want.
Start calling Anthem now and get a case worker also try calling/talking to your HR they are also the ones that set up the policies.
Good Luck,
Robin

4'10" - 47 I'm short but not petite and I will weigh more than a 5th grader
Start weight 220 
"Be who you are and say what you feel because those who mind don't matter and those who matter don't mind"  Dr. Seuss

Carmelita
on 10/18/09 2:57 am, edited 10/18/09 2:57 am - Four Corners, NM
dmike98
on 10/19/09 3:48 pm, edited 10/20/09 3:42 pm - OH
Thank you for the help, I checked and my surgeon is IN NETWORK and the hospital is a "Blue Distinction Center" so I hope things move Fast. I will finish up my required evaluations on Wednesday 10/21 so hopefully the DOC will submit the paperwork. I forwarded my policy to his people and they didn't say there would be a problem so I am keeping my fingers crossed.
Thanks for the compliment about the pics. The 1st pic ( me standing up in the black uniform) is  from 2005 when I was about 210-220lbs. The other pic is my ID picture from work taken just the other day 305lbs.
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