NCHope 0 Posted June 15, 2012 Hello, I have anthem ins. and bmi of 38 with sleep apnea. I am on my 8th day of waiting for approval. I can hardly stand it! Does anyone know if anthem is the same as bcbs? When I call anthem they are in Georgia does that mean I have anthem of Georgia even though I live in another state? Just wanted to see if anyone has a similiar situation. Thanks! Share this post Link to post Share on other sites
Jean McMillan 2,973 Posted June 16, 2012 You have whatever Anthem insurance is printed on your subscriber ID card. If you're confused about it, just call them and ask. It doesn't really matter where they're located as long as you have coverage with providers in your area. I live in TN and have Anthem BC/BS of CT because my husband is retired from the state of CT. Providers submit claims for our medical care through BC/BS of TN, who then recover the money from Anthem BC/BS of CT. Your WLS coverage and approval will depend on the terms of your particular policy. Anthem could have 1000 different policies for 1000 different organizations or individuals (probably more!). Anthem took 2 weeks to deny my band surgery and another 2 weeks to approve it after I appealed it. My BMI was 39.9 and I had several co-morbidities. Share this post Link to post Share on other sites
NCHope 0 Posted June 16, 2012 Why did they deny it at first and what did you do to get them to approve it? thanks Share this post Link to post Share on other sites
Jean McMillan 2,973 Posted June 16, 2012 They denied it because they said my co-morbidities weren't bad enough to make the surgery a "medical necessity". In my appeal, I told them how much they'd have to pay to treat my co-morbidities (high cholesterol, sleep apnea, etc.) until I'm of Medicare age. I guess that convinced them! But that was back in 2007. Anthem seems to have loosened up a bit about WLS since then. Share this post Link to post Share on other sites