Question:
INSURANCE BCBS PPO?
Does anyone has BCBS PPO and called the 1-800 number on the card before seeing an dr. to see if the wls ( gastric) was covered and they tell you "NO'0!!!!! cause I'm very confused I see alot of people here the has bcbs ppo and the surgery was covered so i'm kinda confused here please inform me? ..... — DREIK1983 (posted on August 27, 2007)
August 27, 2007
It all depends on what is covered under your particular group policy. I
would call them back and ask if it is a covered benefit with your plan.
— ChristineB
August 27, 2007
I don't have BCBS but I know when calling an insurance company some of them
are just stupid and will give you incorrect information. I had to call mine
6 times...before I got the correct answer (well my surgeon's office called
the 6th time I was tired and fed up) sometimes as the person paying for
this insurance the person on the other line I guess isn't getting paid
enough to look up correct info. Keep trying or have your PCP call them and
ask!
— bridgadean
August 27, 2007
BCBS has several different plans. I have BCBS but I have the highest
priced pkg through my job and I am having surgery in two days. After, with
my plan, they will also cover removing skin from my stomach and breast lift
or augmentation. I would definitely call them again to find out what
specific plan you have and having the diagnosis number is helpful too.
Hope this helps.
— PAWLLA L.
August 27, 2007
I have BCBS PPO. At first they denied my request because my BMI was 39.9.
They agreed when my BMI was 4o (thank God for monthly bloating!). BCBS is
funny though. Call them again because some companies do not pay for the
obesity Surgery Rider. Ask them if your company has the rider and tell them
your BMI is 40 or more. Good luck.
— AllieT
August 27, 2007
It all depends on the policy. BCBS has hundreds of different plans, and
each one is different. I have BCBS of Alabama (PPO) even though I work in
Mass. My employer has a special rider on the BCBS policy that differs even
from the regular BCBS AL policy on gastric bypass. If you have your
insurance through an employer, talk to your HR Department! They will have
specifics on your particular plan. Good Luck!!
— sbonner
August 27, 2007
Check in you booklet. It should have all the provisions of what is covered
and what is not covered. I have BCBS HMO and I got my procedure paid. But
also look at what your employer plan has purchased. They may have an
exculsion to not cover this procedure. GOOD LUCK...
— The One
August 27, 2007
I HAVE BC/BS PPO AND I HAD SURGURY 2 1/2 YEARS AGO, IF YOU HAVE THE POLICY
THRU YOUR EMPLOYER YOU NEED TO SEE IF THEY HAVE THE RIDER THAT COVERS THIS
PROCEDURE NOT ALL EMPLOYERS HAVE IT.....MY EMPLOYER USES BC/BS ALSO BUT
DOESN'T COVER IT BUT MY HUSBANDS BC/BS POLICY DID.
— Lil' Booty
August 27, 2007
I have BCBS Federal and they paid for my surgery. I went to the doctor and
they submitted the necessary documentation and I had my approval in two
weeks. The only out-of-pocket expenses I had was for my nutritional
evaluation and my co-pay for the hospital.
— AngelaC.
August 28, 2007
The coverage depends on what your company has.......... some have excluded
WLS. Have your bariatric help nurse call the insurance company and see
what they suggest in order to get it covered.
— dthomp
August 28, 2007
I have BCBS and they covered everything. My BMI was 44.5 and I had no
co-morbidities. Don't give up. You may also want to check with your
company's insurance administrator, mine was quite helpful.
— BrownLC
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