brownbeauty

I went through the Pre-op process with the surgeon that I would like to do my lap band surgery about 4 months ago. Back when I had United Health, the surgeon's practice was not IN Network so they did not submit to insurance. I have since changed coverage (my husband got a new job). March 1 we will have Blue Cross Blue Shield, who is contracted with my surgeon's practice. The insurance department has seen 100s of surgeries approved with Blue Cross Blue Shield. I am so very anxious to have the surgery done, I would like to submit the claim for the Lap Band March 1, the day coverage starts./ Do you think that is a good idea? I am pretty sure I will be approved, my BMI is 44. The policy states that obesity surgery isn't covered unless it is deemed to be "medically necessary" - which mine is, I am 28 with HBP and Morbidly OBESE. Please advise as to what I should do. Do I wait it out or submit right away?:smile2: Thanks! Brown Beauty ♥

I went through the Pre-op process with the surgeon that I would like to do my lap band surgery about 4 months ago. Back when I had United Health, the surgeon's practice was not IN Network so they did not submit to insurance. I have since changed coverage (my husband got a new job). March 1 we will have Blue Cross Blue Shield, who is contracted with my surgeon's practice. The insurance department has seen 100s of surgeries approved with Blue Cross Blue Shield. I am so very anxious to have the surgery done, I would like to submit the claim for the Lap Band March 1, the day coverage starts./ Do you think that is a good idea? I am pretty sure I will be approved, my BMI is 44. The policy states that obesity surgery isn't covered unless it is deemed to be "medically necessary" - which mine is, I am 28 with HBP and Morbidly OBESE. Please advise as to what I should do. Do I wait it out or submit right away?:smile2: Thanks! Brown Beauty ♥

Congrats to you! :smile2: Where in PA are you going? What insurance do you have? I am in PA too.

I am so mad right now - I don't know how to feel!!! We have been struggling alot lately with our budget and extra money - money is really tight. My husband started looking for a new job with "higher commission potential" smack dead in the middle of me going through the pre-op clearences - I had my second support group last night and my physch evaluation is scheduled for next Tuesday. This is the last thing I need to do before everything is submitted to insurance. He is going in for a second round of interviews this week and has no idea of what the insurance is or when benefits are effective for new hires! The last time we spoke about this, and I mentioned the surgery – and how him changing jobs would directly effect me not being able to get the surgery on time or not being able to get the surgery period! He just says, I can still get it but with the new insurance. Well I don't know what the new carrier will be!!!! I already talked to my current insurance company (United Healthcare, Choice Plus) and they cover the surgery 100%, since my <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" /><st1:stockticker>BMI</st1:stockticker> is over 40. I guess I am just ranting but I get so angry knowing that this may push everything back or call everything off all together – because of the new job! Is it selfish of me to think like this? Any ideas of how I can approach him about this without causing a HUGE blow-up, I do not have the patience! I am this *!* close to forbidding him to take the new job until after my surgery – OR ELSE! :angry

I am in the stages of all of the pre-op clearances required by my surgeon's office. Even if my insurance company doesn't require these, they do. The physiological evaluation is not covered by insurance and is $250! I don't really have that kind of money and will need to move some things around to pay it. I want to get it scheduled asap, this is 1 of 3 last things that I need to get done before the surgery can be scheduled. (physc. eval, nutrition class - which is also NOT covered by insurance and is $200 - and last support session) All of a sudden, I have been having thoughts that my insurance isn't going to cover it (UHC, choice plus) - and I would hate to spend $250 that I don't really have for this and not be able to get it done. I have a call into my surgeon's office to see if they can answer my questions as well. What was your experience with this? :help: Thank you! Brown Beauty in Philadelphia