Considering revision/looking at insurance

I had a lapband 10/22/07.  Right now it is NOT fun and not working.

We can change insurance in January.  Our choices are BC/BS or UHC.  We're in Oklahoma.

Anybody have any experience with either one trying to get them to cover a revision?  BC/BS covered my band.

I have BCBS National EPO/PPO and they are paying for my revision this morning.  I had them when I was banded in 2006 and luckily they approved my revision as well.  I can tell you that my doctor's office sent over 68 pages of info & test results to them and they went back and forth as to whether or not they would approve.  Took a week but they finally agreed......I have no cap off on my plan so the woman said ok.  

 I have BCBS MI and they have certain criteria that has to be met for in state doctors.  I chose to go out of state and the only thing they would tell me is that it had to be medically necessary and would not give any prior approvals.  My revision was on 10/3.  I will have to wait to see if they are going to pay or not.

Even so, each plan within a company can be different.  While I have a plan that covers wls there are other plans under the same insurance company that may not cover.  I think it comes down to what your employer selects.  

I would suggest calling both insurance companies and see if you can get any further information from them about what their policies include or ask the employer for a copy of what coverage both insurance plans entail.

I had united healthcare for my band last June 2006. I am getting revised to a sleeve with BC/BS of michigan. I live in Texas, but my employer is based out of michigan. It took them 8 weeks to approve my revision. It is coded as a revision only, otherwise they would not cover the sleeve. I would check out both. Call their 800# before you decide and find out what the criteria is. I had a better experience with United.

Sally J.

DO NOT FOR GET!!!! January is coming, some big changes are coming too, I am not happy about this!! We have BC/BS FEP BLUE Standard. Thank God we don't have the basic plan, it is even worse!!!

One change is going to be 20%- instead of 15%  any services.. another is $20.00's for our co pays. That is not including What is not covered in our plan. Our co pay for prescriptions is going up too.

"ANY OUT PATIENTS WEIGHT LOSE SURGERY  WILL NOT BE COVERED"  ANOTHER WORDS YOU MUST BE ADMITTED TO HOSPITAL FOR AT LEAST ONE OVER NIGHT!!!

We just got out new health insurance book two days ago..These are just a few things changing come January 2009..

Now because I have to start all over with a new surgeon, Dr. Kelly in Worcester, Ma. I will not be able to have surgery this year. I was told over the phone, by my new surgeon's office! Plus I have to start EVERYTHING all over!! So I am pretty upset now! And new surgeon also requires his patients to go through his program. We must pay for it too. I heard it is going to cost a lot of money like close to $1,000.00's!! And it is out of the pocket. Not covered by my insurance!!! Also I can not even see him until after I attend his WLS meeting.. Sorry for venting.. Thank you. Alizka