Well I Found Out Today That.....

[Wanda Bragg 8]

Today I called my surgeons office to see if they can submit my paper work for both insurance at the same time because I know one will deny it and that would make my other pay for it. I got a call a few hours later saying that because my primary is not accepted where I want to have my surgery that I would have to go some where else to have my surgery if that is the case then I have just wasted six months of doing doc visits for nothing, but the kicker is the office that I would have to go to is 2+ hours away from where I live. So the lady that I talked to said that I pretty much have no option but to go where my insurance it accepted. Which I think is crap because my secondary is accecpted at the surgeon that I want as mine. So my three options are 1 either go to another surgeon and start over and possibly not get accepted for the sugery 2 stay where I am but have to wait months and months to find out if i can even have it there in the first place and 3 dont have it at all. I want number 2 to be the one i get but who knows.

wanda

[LosingItForMe2011 320]

If you have two insurances...can you drop the first insurance that you state does not cover surgery at the doctors office you want?

[Wanda Bragg 8]

That would be great if I could do that but they said that I could not.

[LosingItForMe2011 320]

When I say drop I mean by one of your employers that you obtain it from. You can't just pick one to not submit to because there is a specific order you have to use depending on the insurance carriers. But if you get both insurances through employers or if you purchase both yourself you should be able to drop one. What insurances do you have?

[Wanda Bragg 8]

I have BCBS and my stated medical as well. I dont know if i can drop it right now with out quitting my job.

[LosingItForMe2011 320]

I see...no you can't drop your employers insurance if you're on state medical as your secondary. I'm surprised your doc doesn't take bcbs though...most do. Perhaps its your specific plan of bcbs? Sorry I can't help more here. Have you tried calling your BCBS plan to see if they'll cover the surgery since the nearest center is 2 hours away?

It's worth a shot. BCBS is always advertising how they help their patients.....I"d try callin.

[Wanda Bragg 8]

I have talked to them and the office has talked to them. The biggest reason why they wont pay for it is because of the doc I want to do the surgery is not in my "home" hospital system. See I work for a hospital that is where the insurance is from. Even if the BCBS would cover it the doc that i go to does not take BCBS. I just wish I knew all about this before I got the insurance. The only reason I got it is because I thought that it would make it easier for me to get the surgery done. But boy did that back fire one me big time.

[TinyMamiOf3kids 1,280]

Can everything you had done be send to the surgeon that is 2 hours away & doctor in that hospital so it's not a waste of time?

[Wanda Bragg 8]

I dunno I have been waiting to hear from the other office. Before I found out originally that the doc im going to now dont accept BCBS I called this other office NEVER got a response from them at all. So I dunno about going to some where they wont even give a call back about info.

[msixkiller 96]

Dealing with same thing right now with BCBS!!! Somewhere in the fine print it says I have a obesity exclusion! Is that not lovely

[Wanda Bragg 8]

Well I found out this last week that since I have bcbs and that the doc that I want is not part of my in-network and that im choosing to go to him instead of a doc in my network that is two hrs away. that my bcbs wont cover anything and since they wont my state care wont either. So its either become self pay or go to the doc that is 2 hrs away. I did finally get a call from that other docs office after my pcp contacted them they said that I have to go to a seminar (sp?) before I can even be seen. So I dont know if I will be able to go there or not. So its just a waiting game.

[Vicki Loichinger 444]

Wanda I am so sorry.

I hope something can be figured out. Don't give up yet. There has to be a better answer to this. It is so frustrating, TWO insurances and you have to battle this. I will keep you in my thoughts and prayers. There just has to be a way.

Going to the seminar, usually your get an apt soon after or may even see the doc at the end of the seminar. So although it is far away it could work for you.

I originally had my lap band seven years ago in Cincinnati, I live in Indpls, so about two hours away, It wasn't convenient but it worked out. Now I am having the revision much closer to home, But if I had to I would go back to Cincy in a minute.