Anyone have experience with BCBS of LA? 6 months waiting period?

[5DogMa 62]

Has anyone else with BCBS-LA had experience with this? My company is self insured and BCBS is the administrator. I guess my company actually pays all the medical bills.

Anyway, what they tell me when I call customer service and what they tell the doctors office are two different things. The main one - 6 MONTHS CONSECUTIVE OFFICE VISITS! I was told 3-4 times by customer service there was no waiting period and only needed to meet the BMI requirements. Then after my doctors office told me about this I called them again and got the same answer - NO waiting period. So I told them what my doctors said and she even put me on hold and talked with her supervisor and came back and said NO waiting period. My co-worker did not have to wait 6 months, but that was 2 years ago. When I told her this, she said that was crazy.

I've been at this since February, picked my doctor in May, have gone through so much testing it's crazy. Now this? I didn't go to one appt in July because I was moving so my doctors office said I have to start counting 6 months from August! I had a fit since I was told there wasn't a waiting period directly from my insurance company so said they would submit, but I will probably have to appeal if I want to have surgery before the end of the year. Then I still might get denied!

I've already paid my max out of pocket this year because of all the testing. If it gets pushed into next year then I have to pay $4,000 more out of pocket. I could have this surgery in Mexico for $5,000 without all this grief.

[amberj 21]

i don't have bcbs, but i had a similar experience. I called and was told i only had to have a bmi of 40 and it be clinically necessary. when i was called and told it was submitted to insurance, i took it upon myself to call the company and ask how long it took for approval. i was told 2-4 weeks for approval and id need a 6 month diet and a 5 year obesity record, BUT it only took a week for approval, I didn't have to have a 6 or 3 month diet and i didn't have to prove a 5 year history either. The financial adviser at the clinic told me it is simply a case by case basis and what what the insurance company told me it's standard procedure. I really hope things work out for you and you have a fast approval!