HELP PLEASE!!!!

HI I HAD MY OFFICE VISIT TODAY , AND IT WENT PRETTY GOOD. I WAS WONDERING IF ANYONE IN 2005 HAS HAD BCBS PPO PAY FOR THERE SURGERY AND IF YES WERE THEY EASY TO DEAL WITH.. THANKS TRICIA

Here's some info to keep in mind with insurance: most of the procedures/services/medications that are or are not covered in your policy are decided by the employer that purchases the policies from the Ins. Company. This means that in some cases your main Ins. Company (BCBS) may generally cover WLS, but your employer may decide not to cover WLS. A simple example is that my ins. (BCBS MN Schwan's) does not carry the Blueprint For Health exercise incentive that pays $20 a month towards an approved workout center if you go 8 times a month. Others in my area that also has BCBS from different employers and has this program available to them and take advantage of it. I hope this makes sense, the bottom line is that your employer may have decided to cover or not cover WLS. However, you can call the Customer Service number on the back of your Ins card and they will look up your policy and let you know. I did not do this because in my surgeon's seminar they stated that some companies make approval harder for people who have inquired about it. My surgeon also said that there are some Ins. companies that are like Cadillac's and some that are like Gremlins, and yes I had BCBS and my surgeon said that it was a Cadillac of a company. P.S. I was approved after the first try; I had a BMI of 46 and asthma, depression, foot pain, stress incontinance, and acid reflux. Nothing major for comorbs.

I realize you are asking people who had surgery in 2005 but I also have BCBS PPO and I had no problems whatsoever. I was approved in less than a week and no questions asked. The surgeon had some problems afterwards getting paid b/c the insurance company paid the wrong dr but they didnt get me involved in it. GOOD LUCK!! sarah

I have Capital Blue Cross PPO (from Central Pennsylvania) and I was approved right away. I'm having surgery next week! Good luck and don't give up if you aren't approved right away!

Hiya Tricia, I have BCBS PPO and am in the process of getting approved. After talking to a TON of people about the insurance thing, it seems like the majority of the trouble comes from the PCP or surgeons office not keeping up with the paperwork, not the insurance company. Everyone just keeps telling me to keep copies of everything and be really proactive. Don't feel bad about bugging them and making sure they are receiving your tests etc. From the limited times I've had to deal with them so far, they seem pretty darn good. Not much of a run around and you actually get to speak to live human beings. They told me that they evaluate everyone differently on a case by case basis. Basically if your surgery center is on the ball and doesn't slack you should be fine. Good luck!!! Keep us posted!

Patricia, You are not alone with thie BCBS PPO.....I also have them and my information was submitted a week ago. I have been trying to find out also, if anyone had problems getting approved through them. I was asked to get past medical history to submit to my insurance....but I don't have a past medical history....so only one file from a doctor I saw a year and a half ago was sent. I'm really hoping that was enough information. I hate this waiting game and wondering!! It's driving me crazy....and I think I'm driving everyone around me crazy in the process!! I wish you the best of luck!! JLO

Hi! I have BCBS PPO and I had no problems getting an approval. I wasn't even required to do 6 months supervised like many are now-a-days. Ya know what I had a problem getting them to pay for? the Sleep Apnea test and the machine...I believe I wound up paying 1/2 for both. But....no problems with the surgery. Hope that Helps! Genny 358/247/170