Question:
Anyone have BlueCross/Blue Shield of Illinois PPO

Anyone with this insurance been covered for a TT. Had my open ryn on April l4th 2003 and I think I am about ready to inquire about it. Can't pay myself so insurance is my only hope. Thanks    — Maureen C. (posted on May 20, 2004)

May 21, 2004
I have BC/BS HMO and they turned me down they said it was cosmetic and unless I had reoccuring rashes or problem they would not cover it and it would need to be documented with several doctor visit before they would even consider it.
   — Cindi A.

May 21, 2004
I have BC/BS IL PPO, and am in the process of seeking approval. The good news is they haven't denied yet. The bad news is they're dragging their feet. I think they're hoping I'll give up and go away, but they don't know who they're dealing with! I waited about two weeks after the surgeon first submitted to ask if BC/BS had received the request and if they needed additional information. They told me thay had received an inquiry from the surgeon, but it was too soon to have any other information--I should wait 30 days for a decision. On day 30, I called them again. They said they needed more info from the surgeon (specifically photos and a procedure code), and that a letter was dictated the day before; it would take a few days to be printed and mailed. I waited a week from the dictation date and called the surgical coordinator. They had not received any letter from BC/BS, so I phoned BC/BS back and asked them to fax the letter to the surgeon. To my surprise, they did. I confirmed with the surgical coordinator the next day that she sent in the requested info, and gave BC/BS another week, which was today. I called again to check on the progress, and was told they did get the requested information and it will take another 30 days. I said that I really needed to get this resolved and scheduled around work. The woman said I was welcome to call back in a week to see how it was going. So I will call every Friday until I have an answer. I really think they are purposefully slow and uncommunicative in hopes that the patient just gives up. So, if you're interested in getting the surgery covered, my advice is to keep on them. Best wishes.
   — Vespa R.

May 27, 2004
Ihad a tt and breast reduction/lift on april 5th of this year. I ad no problem getting approved .If you need more answers you can email me@ [email protected]
   — JUANITA U.

May 27, 2004
Update from my 5/21 post: BC/BS approved a panniculectomy today! They won't cover the arms or the extra work the surgeon is going to do with liposuction on the pubis mons, or the flab that hangs over the side of my bra, but I never expected they would cover those. The panni IS medically necessary--the rest is mentally necessary. So, I'm very happy. My advice continues to be to stick with it and follow up--politely but firmly.
   — Vespa R.