BlueCross Blue Shield of Michigan and Medicaid

[Ready4aNewLife 1]

I am a 19 year old female that weighs 284 lbs. I have been overweight my entire life, ever since I can literally remember, I mean even in my kindergarten school pictures you can tell how much more I weigh than the other children! I am so sick of tired of being this way. I wake up and look in the mirror every day just to think how disgusting I look. I was diagnosed with sleep Apnea yesterday and it really scares me. I need to do something about this. I have been on so many yo yo diets but just keep gaining more weight back and then some. I have put at least over 200 hours in researching all about weight loss surgeries. I think that getting the Vertical sleeve would be the best option for me but I really cant afford to pay larger out of pocket expenses. I have Blue Cross Blue Shield of michigan through my mother and I have Michigan Medicaid throught the state. Since I am under 21, Medicaid pays all of my copays and deductibles. Does anyone know how the insurance thing works if my BCBS is my primary insurance and Medicaid is my secondary insurance? Will BCBS pay a certain percentage and then my Medicaid pay the rest? Do you think that my Medicaid would pay my copays and deductibles that BCBS wont pay? Did your insurance pay for your pre op liquid diet? Does anyone else have a primary insurance and secondary insurance or know anything about this to help me?

[sarsar 824]

I don't know the answers to your questions but I would suggest first calling your primary insurance and see what they say. Write down all of the questions you have so you don't forget while you are on the phone with them. Then, call your secondary insurance and see what they say. This way you will get the right answers and be able to take the next step.

Good luck!

[Nancy Rivers 24]

Definitely call your insurance to find out. I have BCBSM as an individual and it is specifically an exclusion on my plan, but your plan MAY cover it. The only way to know for sure is to call and find out.

[fluffychick 0]

If you talk to your Dr. and get the procedure billing code or they are using you can contact your ins. give them that code along with a diagnostic code and they can tell you if it is covered and how much. Good Luck! I hope everything goes well.

[anonynurse 13]

Whether your insurance through BCBS will cover it is anyone's guess. You will want to call, as advised above, and ask if it is a covered procedure or not. If there is a specific exclusion for bariatric surgery there is not a lot you can do about that.

As far as the medicaid goes, here in Texas Medicaid does not cover bariatric surgery at all and won't pay. It just depends on your state. That too you will want to make a phone call and see.

No insurance will cover the cost of the preop diet. You'll just have to put your grocery budget toward paying for it rather than whatever it is you usually buy.

Best of luck.

[Ready4aNewLife 1]

Well I have called both my insurance companies already and I know that my BCBS and Medicaid does cover bariatric surgery. I was just curious if anyone knew how things worked when you have a primary insurance with BCBS and medicaid as a secondary insurance. How does the coverage work for medicaid as a secondary insurance? Will medicaid cover all of what BCBS wont cover or just a certain percentage?