Question:
How long is the wait for approval with Blue Cross?

I am considering switching to BC/BS Comprehensive Major Medical in March. Is there a waiting period before you can apply for WLS? And how long is the approval process? I presently have Kaiser and I'm not willing to wait an entire year to get this procedure. If I have to wait a long time with Blue Cross then I will try to finance my operation. I'm ready to start living lighter NOW!!    — blank first name B. (posted on December 27, 2001)


December 27, 2001
I switched from Kaiser Northern CA in March of 2001 to Blue Cross PPO. I had my first appointment on Aug 15, 2001 and my surgery was performed on September 17, 2001. Blue Cross approval took 1 week. I didn't even qualify for surgery according to Kaiser. I didn't even need a referral from my PCP on Blue Cross.
   — blank first name B.

December 27, 2001
See if you can see the policy from BC. Each state can have different laws on pre-existing conditions. Also, if this insurance is through your employer, they may have some policy on this. My employer does not allow for pre-existing conditions to be used if you are moving from one insurer to another.
   — [Anonymous]

December 27, 2001
I have BC/BS Community Blue PPO, and they were terrible in approving my surgery. It took approximately 2 months, and a daily call from me, and a weekly call from my Surgeon. They ended up approving me, only after I called to file a grievance, and it was at 11:00am the day before my surgery. I hope you have better luck than I did!
   — Chloe S.

December 27, 2001
I'm from Upstate New York and have Blue Choice Option which is Blue Cross for those of us on Medicaid. And they made my life a hell for nine months. I had approval ALL along the way from "everyone" I had to see. But Blue Choice Option wanted me to see "their people" hoping that someone would deny me. Everytime someone said "yes" they wanted me to see someone else doing the same test (or whatever). It was a freaking nightmare. I never had all this trouble with Prudential when I was seeking approval for NON WLS surgeries but Blue Cross was terrible.
   — Danmark

December 27, 2001
I have BCBS of CA but live in Mississippi. I was approved within a week with NO problems except a quick phone call after they finally admitted they recieved the paperwork. I can tell you this though. BCBS in each state differs. BCBS of Mississippi doesn't approve WLS for any reason at all. BCBS of CA was easy. It definately depends on where you live.
   — Barbara H.

December 28, 2001
I have BC/BS of California. I am in the approval process right now. Blue Cross has nothing to do with it. According to them, I am covered as long as I have a BMI of 40 and it is medically necessary. That's where my problem is. My medical group has to approve it. The surgeon's office sent over the information on 11/30/2001 and I call every other day (sometimes more often than that) and they still do not have an answer for me. I guess what I'm trying to say is, it depends on your PCP and if there is a medical group involved or not. Blue Cross hasn't even been in the picture for me. Good Luck!!
   — Carole S.

December 28, 2001
I HAVE BLUE CROSS/SHIELD OF BALTIMORE AND IT TOOK A LITTLE MORE THAN A WEEK TO GET MY APPROVAL, BUT I ALSO CALLED THEM EVERYDAY FOR A STATUS AND SENT IN MY OWN REQUST FOR APPROVAL ALONG WITH MY DOCTOR'S. I DON'T KNOW IF THOSE THINGS HELPED OR MADE A DIFFERENCE. I DIDN'T ASK, I WAS JUST GLAD TO BE APPROVED.
   — washar




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