I am just starting the process of looking into lap band. I previously contacted BCBS who told me that I would be covered but I had to have a current bmi over 40 (which I have) and prove through medical records that my bmi has been at 40 over the last 5 years. After that my deductible would be $2,000.
Well I went to a seminar at a center yesterday, and the patient coordinator who checked our coverage during the presentation said that the only requirement I had was my current bmi being over 40, and if I used their out of network surgeon I wouldn't have a copayment just a small fee for the anestethia. Does someone have any insight into why this is the case? I have another appt this week so I plan on looking into more for sure.
I think it has something to do with the fact that the other 2 surgeons and the center itself is in network, but the surgeon who would be doing my surgery comes down from LA (I live in Vegas) is out of network? I would be estatic if this is the case and I have hardly any out of pocket cost, but I'm a little skeptical. I don't want to have the procedure done and end up with a 20,000 dollar bill. On the other hand I don't think this center would move ahead and perform the surgery without knowing exactly how they are getting paid. Like I said I am going to find out for sure but just was wondering if anyone had some advice. Thanks!