blue cross blue shield

[tra5 0]

Hi kindredspirit -

I was initially declined for the procedure, but received approval from BCBS just yesterday. Keep up the good fight!

Nathalie

i want to no how did you get approve i am having to go to a lawyer they delcine me 4 times i am so upset

[piercedqt78 658]

I STILL havent heard anything back from BCBS. Surgeon's office spoke with them on Wednesday..and it was still under review.

I'm so anxious to hear something....

I hate to be negative, but the insurance company can take upto 30 days to review your information. It can happen faster, but they have the right to take a full month for a review. Good luck to you. ~Mandy

[airwayman 2]

I have BCBS OF MD through my hysbands employer Baltimore County Government. As was explained earlier, each policy is different with BCBs even within the same state. It all depends how much each company wants to pay for the policy

Phyllis, I'm no expert, but, while researching my own situation, I found that each BCBS has it's own written policy for WLS. North Carolina's was titled BCBS of NC Corporate Policy for Surgery for Morbid Obesity. It's several pages long, available online, if you know where to look, and is their reference guide for approving/denying coverage. Additionally, each company who buys a policy has the option of purchasing weight loss surgery. The companies don't specify which type of WLS surgery or any of the specifics like BMI, dieting history, etc. If they purchase the option, they rely on BCBS to administer the policy. For some folks their first fight would be to get the company to purchase the WLS option; some have succeeded. Then the second possible hurdle is whether the BCBS in question covers AGB (adjustable gastric banding). In my case, BCBS NC moved gastric banding from "investigational" to approved Jan 29th, 2007.

[Madine 0]

Hi Ragdollx19

We are in the same area. I have Dr. Snow and I believe Drs. Marsden and Snow are in the same building on Precinct Line Road. Dr.Snow's office has not dealt with Fed Emp before and they are very concerned.

Madine

[rcoeters 0]

I used a lawyer from obesitylaw.com. My doctor's office had to fill out a bunch of papers so that the lawyers could decide whether or not to take my case. But, the papers just asked for my medical info that the doctor already had. It didn't take the law firm too long (maybe a month) and it was free.:clap2: But, about the time they filed my appeal, BCBS of NC decided to add Lap Band to the list of procedures that they cover anyway.

[jchazen22 0]

Beachgirl,

I know what you mean, I am single,60 yrs old and pay 300.00 a month for Regency Blueshiled. With diabetes, arthritis, FMS, Gallbladder disease and other things, I thought it would be a shoe in. When they announced that as of Jan. of this year they would pay for the Lapband, I was really excited after 2 years of looking and working on this. But! my company has an (exclusion) # 27 that will not pay for any thing dealing with weight loss. I have even had to have my family doctor make sure to put it in my notes but to not mention any weight loss on my visits or they will not pay for office calls. Makes me wonder why I have the insurance. But, after 2 years, I am not giving up!

[ragdollx19 1]

Hi Ragdollx19

We are in the same area. I have Dr. Snow and I believe Drs. Marsden and Snow are in the same building on Precinct Line Road. Dr.Snow's office has not dealt with Fed Emp before and they are very concerned.

Madine

perhaps they should talk to Marsden's office, I think they have done a few since Jan 1?

[Madine 0]

Thanks for the info.

Madine

[cfred 2]

I have a BMI of 42 with federal bcbs and did not have to do any diet or ANYTHING other than ask for approval through my surgeons office. I got approved in 3 days.

Hi, I also have BCBS Fed and I did not have to go through anything. My Dr's office said that the only requirements that BCBS Federal has is that your BMI be over 40. Which mine was (is). My request was sent on a Friday, and the office called on the next Wednesday with an approval. I started all of my process at the end of March and my surgery is scheduled for May 10th.

[Melissa S 1]

I just got a call from an RN at Empire BCBS of DE ..... and.......

I'M APPROVED!!!!

I screamed and asked her to repeat what she told me... just to make sure I heard her right!!!!

[PattynVA 0]

Hello to everyone!

I'm new here, but have been reading the posts from this forum and find them so very interesting and supportive.

I am intrested in obtaining a Lap Band, as I've been overweight since a teenager. I feel this is exactly what I need to get rid of this weight and keep it off.

You all are a great bunch of folks, I truly enjoy reading your comments and I've learned so much. I'm about 125 lbs overweight and I have a multitude of health problems. Most of which would improve with weight loss.

I have Optima Health Insurance, is there anyone here that knows if they cover the lap band surgery? I called the Ins. Co. and was told, "NO", however i believe, if it's medically necessary, they do cover it.

Looking forward to being a bandster, one day soon.

Patty in Norfolk, VA

[Melissa S 1]

Welcome Patty...

Have you searched for a surgeon or have you attended an information session?

Most surgeon's offices are very familiar with insurance and what is covered. However your best bet would be to call the insurance company directly or better yet.. obtain a printout or handbook for your specific policy...that way you can get a definite answer as to what is and what is not covered...and you can avoid the sometimes "not so helpful" reps in customer service*

Best of luck to you!!!

*By no means am I putting down customer service reps...I myself have worked in a customer service environment. I have experienced many times one answer from one person and a completely different answer from another.... and I have learned when it comes to health or money, you most definitely want a correct answer!!!

[PattynVA 0]

Welcome Patty...

Have you searched for a surgeon or have you attended an information session?

Hi Melissa,

Thanks, for the welcome!

Yes, I have found a surgeon. I'm attending the information seminar next week on May 16th.

I'll ask then about my health insurance coverage, as I know a few other co-workers that had gastric bypasses, and all had my Insurance.

[PattynVA 0]

I'm not sure how to work these quote's on this board, yet.....LOL

[cmacinga 0]

I had absolutely NO problem using Blue Cross Blue Shield Anthem. They are one of the BEST insurance companies for Lap-Band surgery. I have them out of Indiana, and it took all but 10 minutes after all the paperwork was there to get approved. I spoke directly to Diane, who did everything in her power to get this paperwork filed quickly. I began on April 6th and by April 13, I was approved.