Premera BC

Has anyone been approved for surgery with Premera BC?

I have Premera and they have a very strict exclusion policy, so I didn't even try. I have to make sure that NOTHING that gets submitted to them has anything to do with the big "O" (obesity) or they will deny the claim immediately. One time the doctor ordered bloodwork for my anemia, and somehow the claim got diagnosed as obesity. Even after it was resubmitted correctly, they refused to pay it! Read your policy and see whether or not it has the exclusion. Good luck!

Charlotte, I have PBC and my company's policy has a strict exclusion as well. I also did not submit a request for coverage because I knew they would deny then they would also be aware that I was wanting to do it and perhaps deny all of my pre op testing. So far they have paid for all of my pre op stuff. My surgeon is very careful about giving prescriptions that are coded for anything but obesity. So just make sure to ask the surgeon you're using to use codes that are not related to obesity. But before all of that, though, you should call and see if there is an exclusion on your policy. If you work for a large enough company they might have a special policy that doesn't have exclusions. It certainly doesn't hurt to ask and it shouldn't ring any alarm bells with them if you do have an exclusion. Hope that helps. Corinna Q