how to find your ins benefits online?

debby01 · October 20, 2011

Has anyone been able to look up online to find out what the benefits are for your health insurance concerning bariatric surgery? If so, how do you do it? I have BCBSMI PPO ford retiree and when I talked to the ins rep the other day, she went so fast through everything and now I'm confused on some parts. The rep said she would send the written part on my insurance for bariatric surgery through the mail. Said it would take 7-10 days to receive. Help!

Janae · October 21, 2011

Here is the link for BCBS Illinois bariatric surgerymedical policy::

http://medicalpolicy.hcsc.net/medicalpolicy/home?ctype=POLICY&cat=Surgery&path=/templatedata/medpolicies/POLICY/data/SURGERY/SUR716.003_2011-03-15#hlink

Also, be sure to verify that your plan hasn't specifically excluded it. You can find this in you plan document, which you should have a copy of. Good luck!

Pammie · October 24, 2011

Hello, I too have BCBSMI< you can find this information by googling bcbsm and it will bring up thier medical policy, from there just type in obesity and that specifc portion will come up, I hope that is helpful to you!

www.bcbsm.com/mprApp/MedicalPolicyDocument?fileId=2006079

Has anyone been able to look up online to find out what the benefits are for your health insurance concerning bariatric surgery? If so, how do you do it? I have BCBSMI PPO ford retiree and when I talked to the ins rep the other day, she went so fast through everything and now I'm confused on some parts. The rep said she would send the written part on my insurance for bariatric surgery through the mail. Said it would take 7-10 days to receive. Help!

5DogMa · November 5, 2011

I have BCBS of LA. I have found out that what it says on line when you check, and what they tell the customer when they call in to check on their benefits, MAY NOT be what they tell the doctors office when they submit for approval or call in to verify coverage. I had verified on line and even printed out the content from the web site. Then over the phone verified at least 3 times with 3 different people there was NO 6 month waiting period to have VSG if you met the criteria of 40+ BMI. I was 42 BMI. Then they told my WLS I have to have 6 consecutive monthly office visits! I am so mad because if they stick to the 6 consecutive month weigh ins and doctor visits it pushs my surgery out until January which means I'll have to pay the max out of pocket AGAIN! This year my max out of pocket was $3,000 which I have already paid because of all the testing, but next year it goes up to $4,000 out of pocket! That means my share of cost would be $7,000!!! I am told by my doctors office this happens a lot. So be careful. I am going to appeal if they deny coverage for this year. My WLS submitted yesterday for approval so we'lll see. Until then my bloodpressure will be elevated. Oh, my co-worker using the same insurance did NOT have to wait 6 months. :banghead: