Hope4Life 0 Posted April 17, 2007 Hi, I am looking for any info you may have on this type of insurance. What they covered/what they didn't, did you have to pay upfront fees? What about meds, and HOW MANY HOOPS DID YOU HAVE TO JUMP THROUGH ? I am exploring this lap band thing, and to be honest, it is very scary. I weigh 265 and am 5'2" tall. I need help badly. Please let me know how it's been for you! Thanks! Share this post Link to post Share on other sites
lo2us 1 Posted April 20, 2007 <p>I use to have Anthem BC/BS in KY. They coverd nothing. My brother is a teacher in VA and has Anthem in VA and he said they cover nothing as well. If you're a teacher there a FEW financing option available to us. Just let me know if I can help. Share this post Link to post Share on other sites
mrspruett 0 Posted April 20, 2007 I have BC/BS of KY. This is kind of strange because I live in Indiana but my husband's work( even though it is in Indiana) has BC/BS of KY). To further complicate the matter, I had my surgery in Cincinnati, OH:biggrin1: . My experience thus far has been great. 1) I was approved in 9 days. 2) The pre-requirements were a psych eval, a nutritional consult, a letter of medical necessity from your family doctor 3)No documented diet was required. 4)There was a $250 deductible for hospital 5) A BMI of above 40 was required if you have no co-morbidities. With at least 2 co-morbidities, a BMI of more that 35 is required. My surgery was 4/9/07 and all is great. Please keep in mind though that from what I have been told BC/BS varies very much from employer to employer. Many employers totally exclude band surgery from their BC/BS policy.Your results may vary. Share this post Link to post Share on other sites
lo2us 1 Posted April 20, 2007 I guess I moved from KY too soon. Share this post Link to post Share on other sites
Nathalie 4 Posted April 20, 2007 I live in Michigtan. Anthem BCBS covered me at 100%, save my $250 hospital co-pay. Fills are covered at my $15 office visit co-pay. I was denied 2x before getting my approval, but all in all it only took 2 months to get approved. I don't have any co-morbidities to speak of. If you need letter samples, let me know. I'm more than happy to share. N. Share this post Link to post Share on other sites
Hope4Life 0 Posted April 20, 2007 Hi again! Thank you for the information! I have been able to determine that the surgery is covered if you meet the requirements. They won't tell me what the requirements are, only my doctor. I have a BMI of 47. I don't know what qualifies as a "Co-morbidity", but I don't have diabetes, high blood pressure or any of that, but I do have a majorly bad family history for heart disease and a brother that is diabetic. I am 44 years old - I need to do something NOW! I do have back trouble and slightly high cholesterol - 223. Thanks again! Share this post Link to post Share on other sites
mrspruett 0 Posted April 24, 2007 Hope4Life- some co-morbidities include sleep apnea(you will need a sleep study to check for this), joint pain(your back pain may qualify), and as you mentioned heart disease and diabetes( I am not sure if family history will qualify as a co-morbidity). Depression can also be factored into your paperwork as a comorbidity if you are on an anti-depressant. Hope this helps! Share this post Link to post Share on other sites