Anyone with Blue Cross Blue Sheild?
I haven't even started messing with insurance yet. I have blue cross blue shield of Alabama through my father. Now, it isn't the same insurance we had when my mother had her surgery three years ago. I'm wondering what some of ya'll have gone through with them? I've read the insurance page but it's so unpersonal it didn't help me. A lot of it said it had to be medically mandatory...but UMMMMMMM I'm OVER THREEHUNDREDFREAKINPOUNDS! No, I don't have a whole bunch of problems. The only thing I have is I have borderline high blood pressure, other wise I'm pretty healthy except for the body aches most fat people have. That's why I'm wanting to do something about this NOW so I don't have to have a bunch of medical problems in the future! It's preventative! I have NO Co-morbities! I DON'T WANT ANY! That's why I'm doing this. Sheesh. I've been overweight since I was nine years old. What else do I need to prove? Sorry for the rant...but back to the point...any experiences with BCBS? Doesn't have to be Alabama...just any state.
(deactivated member)
on 7/31/07 11:25 pm - MN
on 7/31/07 11:25 pm - MN
Well, I can tell you about Blue Cross Blue Shield MN. Within a week of submittal by my surgeon's office, they approved me. My plan was 80%/20% with an $1800 out-of-pocket max.
I know the lap band and the RNY are two different procedures. So I wonder how it differs and I'm sure the difference from state to state is pretty huge. I know that BCBS of AL Federal cracked down on approval, but I'm not sure about the PPO.
And I'm not sure a lot of people say you need 6 months of dieting before approval and that weigh****chers counts well I did weigh****chers for almost 6 months a few months ago and I also did a doctor moderated lipo shot thing for a few more months, would that count?
I finally broke down and sent a message via email last night to customer service...about what I would need and qualifications and stuff. This insurance mess is so confusing.
I have BC/BS of PA. I went through the 6 month diet and did everything needed. My BMI at the time of surgery was close to 50 and my doctors office sumitted and with in 1 week I was approved. I also at the time of my scheduled surgery had my policy change. I went from Select Blue to PPO Blue and my doctor's office was even able to get it post dated so that my new insurance would cover. I have awesome benefits....not sure what your plan is like...and they covered my insurance 100%. The only out of pocket costs I had were my 10 dollar office visit co-pays. Hope it goes as well for you!
Call and find out what their requirements are... more than likely you will need 5 years weight history... of those 5 years you must be a BMI of 40+ OR 35+ with co-morbs. They may or may not require a supervised diet so you want to find that out ASAP.
I did not meet their basic requirements but was approved... it took 4 months and 3 appeals but I got it... you can read more on my profile about it.
First visit to surgeon - 288 ~ bmi 45.1
2 week pre-op 252 ~ bmi 39.5
Total lost - 153 Since surgery - 117!
Goal weight - 155 (mine) 180 (surgeons)
Current weight - 135 (2020 I lost 10lbs due to dedicating myself to working out more and being in better shape)
1/14/2025 still maintaining 135 :-)
Extended TT, lipo, fat injections - 11/2011
BA/BL/Arm Lift - 7/2014
Scar revision on arms - 3/2015
HALO laser on arms/neck 9/2016
Thigh Lift 10/2020
Thigh Lift revision 10/2021