Insurance Angst!

[LovelyLauren 0]

Hi everyone!

I'm looking into getting the band but am worried about the insurance clearing it. I have Anthem Blue Shield. Has anyone worked with them or know anyone who has? What experience did you have?!

[sillysallysunshine 0]

I have Anthem BCBS in Arizona, but I have to tell you... the coverage (and the requirements) are based on what your employer put in their policy. My employer decided to put WLS in the plan for us to use, but a lot of employers will not or do not. I am going through True Results.. and before my first appointment they were able to verify whether or not the surgery would be covered.

That being said, I got my approval within two weeks of my first appointment (once my pre-reqs) were done - and I did them as fast as I could! lol) I am scheduled for May 13th. I got to know the case manager for my employer with BCBS. She was the one that called and told me that I had been approved and in my opinion, she was awesome!!!

[Manda87 3]

I have Empire Blue, but Anthem is kind of the same. All of the paper work they sent me was addressed from Anthem.

With my experience, they have hospitals that they approve. I didn't pick one of those hospitals, so my doctor was out of network. It wasn't hard to get approved. I wasn't required to do any diet.

I would give them a call and see what they require pre-op. :thumbup:

[LovelyLauren 0]

Thanks Silly Sally and Manda!

I'm not so worried about our plan allowing WLS due to the fact that my mom is the CEO and get's to make whatever plan she wants. I was just wondering if they're slow on approving you like so many insurance companies are. Glad to hear they're not too bad! Thanks for your help ladies!

[Manda87 3]

Thanks Silly Sally and Manda!

I'm not so worried about our plan allowing WLS due to the fact that my mom is the CEO and get's to make whatever plan she wants. I was just wondering if they're slow on approving you like so many insurance companies are. Glad to hear they're not too bad! Thanks for your help ladies!

I got a response back within a week and a half. :thumbup:

[gigi0504 0]

Hey there. I have Anthem BCBS and I am in Texas. I work for a very large company and I kid you not my approval process and surgery date took me about 1 month. I started looking into True Results in February andin the beginning of March had my first appointment, got my insurance approval the end of March. They are paying for 90% of the surgery. I just pay 10% and since my insurance has a deductible cap of 1k, I pay exactly 1k.

NOT KIDDING. How could I NOT go through with the surgery.

Anthem has been very quick on everything for me and approval went through with no problems at all. I am 5"4 and about 235lbs and have a BMI over their limit and am boarderline diabetic.

Good luck and best wishes!

[kute_n_pretti 1]

I too am so worried about getting approved. I also have Anthem BCBS PPO.....i have hypertension and depression....Today I go do my Psych test b4 they submit it to my insurance. I am a nervous freakin wreck! I just want a surgery date!

[HappyMom 1]

I have Anthem BCBS of California and I was approved in about 5 working days.

The only thing that Anthem required of me was a psych consult, dietitian visit, and photo copies of my previous WW weight trackers (just to show that I have attempted in the past to lose weight).

It was very easy and straight forward. Anthem was great to work with!

Good luck to you!

[JustAskinThx 0]

I am in FL but our Anthem BCBS is, I think, BCBS of Virginia. At any rate, it was pretty smooth sailing. Last year they did NOT cover bariatric on our particular group policy, but as of Jan 1 they did. There was no six-month dr. supervised diet. They did require the psych eval and nutritionist appt. They did ask me to have a thyroid test to be sure my overweight was not easily remedied. They did try to tell the fearless Tammy at my dr office that they don't cover it, but she reminded them that according to the written policy, they do...and then it all went very smoothly. They approved it for one night's overnight at the hospital but I preferred one-day surgery, and it worked out fine. Best of luck, just jump through those hoops and don't give up! (I had the surgery on April 22, btw.) From start to finish, from the date of the seminar to the date of surgery, was two months less three days. Some of that was the whole getting-then-waiting-for-appointments with the other specialists. The actual approval took maybe a week or 10 days.