Anthem Keycare PPO

I currently have Anthem Healthkeeps and I posted something about them a couple days and did not get a very good response. Does anyone have Anthem Keycare PPO and had any luck? I dont think it is a matter of getting approved, I have enough health issues to knock someone over and with a BMI of 51.2??? But with my work I can switch to Keycare if I want to, let me know! Thanks!

Hi Becka I think your best bet would be to call your insurance company direct with your policy and see if they cover the surgery. If they cover it, that is half the battle, and you will at that point know how to proceed. If they cover it, you can then ask what documentation you will need to submit to them at that point, and also talk to your PCP......Good luck! HTH! Dianna

Hi, I have Anthem, but it is not Keycare. Anthem in general has a pretty basic policy, either 100 pounds over your ideal weight for your height, OR a BMI of 40 or higher, OR a BMI of 35 or higher with additional issues (like Diabetes, High Blood Pressure, Etc.). You only need to meet 1 of those 3 for approval (unless Keycare has a special policy so double check with them). I was approved on the first phone call in a matter of minutes! Good Luck! Vicki

Hi Becka, I am the Plan Administrator for our Anthem Key Care Plan and there is no coverage for obesity surgery unless your company pays monthly for the Obesity Rider for every employee on your plan. Weight, BMI, etc. don't even come into play unless we have purchased the rider. So be sure to check with Anthem. Karen

I work for Anthem and the best advice I have is to call and see what is covered under your HMO policy. If it is covered, stay there but make sure you get all of your referrals. If it is not then contact your group administrator and see if it is covered under the Keycare policy. Any policy needs to have the rider to have it covered as obesity surgery is not a mandated benefit. Let me know if I can help in any way. Tammy