Blue Shield of CA

[LilMissDiva Irene 3,282]

Anyone had any experience trying to get coverage for the Sleeve surgery from this insurance Provider?

I have Hills Physicians specifically.

I have placed a question in the "contact us" email inbox for my provider and will need to wait a few days for response. If I don't get one by Wednesday I will call.

Thank you!

[LilMissDiva Irene 3,282]

Well I turned in an email request to my Insurance Provider with specifics and here was my response:

Thank you for your question about medical benefits.

Coverage is provided for medically necessary medical and surgical treatments of obesity conditions, such as:

1. Office visits for treatment of obesity when medically necessary as determined by the Personal Physician; 2. Surgical benefits for members with morbid obesity that meet Blue Shield Medical Policy and clinical criteria for defined procedures and services which have been approved by their Personal Physician.

You should contact your Personal Physician to discuss your personal options for surgical services.

Please contact your Personal Physician and HMO medical group for authorization and benefit information.

While not all that great, its not bad either. I asked about the sleeve specifically and they did not say the wouldn't do it. So, now I am going to set up an Appt to see my PCP and tell her what my plans are. I hope she will agree with me! If not, then I will have to leave and see another Dr. :'( That would be sad because I really like her.

[Eureka-C 20]

I have bcbs of ca and was denied due to it being experimental. I have begun the appeal process and I am waiting for the next step. I cried when the surgeon's office called and told me. Good luck and could you post when you find out more?

[LilMissDiva Irene 3,282]

I went self pay actually, I was sleeved on 9/15/10... so I won't be doing any more research on this. Sorry!