Interested in the Lap Band

[Esme22 0]

Hello Everyone,

I really want to get the lap band but it is not in my budget. I currently have HMO insurance and of course that does not cover the procedure. I will be able to change my insurance in about a week, can anyone tell me what PPO i should go for the insurance will be with Blue Cross Anthem? Any help will be greatly appreciated. :smile2:

[HappyMom 1]

Hello -

I have Anthem BCBS PPO of California and I was banded with no insurance issues on 3-25. The only requirements for final approval was a dietitian visit, psych consult, and to show that I have made attempts in the past to lose weight. For that last part I photocopied my previous WW weight trackers and my credit card statements for the last year of on-line service.

You will have to read your policy very carefully regarding weight loss surgery. As a company Anthem BCBS will cover LapBand, but some companies put special exclusions in their contract with BCBS that will limit the coverage for weight loss surgery. As was explained to me by BCBS... this is not their policy restrictions, but your companies imposed restrictions....I guess that it makes the premiums that they have to pay to BCBS smaller if they exclude various procedures.

I really wish you good luck in your journey. If weight loss surgery is not excluded by your company your experience with Anthem will be very easy and quick!

[Esme22 0]

Thank You so much I will look for that. You have been alot of help. I will post how as soon as i have answers. THANKS AGAIN

[Esme22 0]

wow i searched the website, now im confused there are so many diffrent PPO Plans which one is the one??? Im not good at this stuff.

[HappyMom 1]

I just checked Anthem and I think that we have the Lumenos HSA (HDHP) PPO plan. On this plan we pay the first $2400 out-of-pocket and then the 'traditional' health plan kicks in (90% them -10% us split) up to $4200 out-of-pocket....then 100% is covered. The out-of-pocket amounts are based on our family of 4.

ALL of the money that our employer takes out of our check for health insurance goes directly into a HSA (Health Savings Account) that we use to pay the out-of-pocket expenses for the year. We control the savings account and use the account VISA or checks to cover all medical expenses. We don't have to pay a cent for premiums or anything else like that....I think that our employer pays that.

It is a good plan if you are very detail oriented. You have to keep meticulous records for all expenditures from that account because it is pre-tax monies that can be audited by the IRS. In the past two years it has saved us thousands of dollars having this type of plan. It is hard when you are first starting off with this plan because you haven't built-up the HSA account. If you get really sick during the first couple of months you may find yourself running out of money in the HSA account and having to cover the expenses yourself...and reimbursing yourself later in the year when the account balance is higher.

I hope that this helps! Good luck on choosing a new health plan....I know that it can be very confusing!

[Esme22 0]

Thank you again your awesome!!!:thumbdown: I will look for that and see if that's the way to go. Thanks for all the help