BCBS MA question...

LTjr · June 19, 2007

Have any of you who are in Mass with BCBS had problems getting approved?

I am being submitted for review with the surgeons tomorrow,then, if approved by them,submission to BCBS?

Would they not approve it if I hadn't been to a supervised WL program?

My BMI is 49 and I have 2 co morbidities....

I have a gym membership(a lot of good that's doing), trying my own diets for years, but never a jenny graig or weight watchers. I've taken pills, slim fast...all that crap.

Has anyone here ever been denied because of this? I guess I am freaking out a little.

Thanks.

NURSEDSD · June 20, 2007

I have BcBs Ma and I just found out last night that my plan does not require any medical authorization or pre cert. I just have to meet the medical criteria and I am good to go. So I called my surgeons office this morning and they are scheduling me for Friday probably... I am so excited I thought it would take a couple of months.. I was at the doc's office on Monday and maybe surgery on Fri. Hope that helps:clap2:

AngelSoftSnow · July 12, 2007

I have HMO Blue New England...has anyone used this type of insurance for coverage. I'm just starting the process and want to know what I'm up against. I have schedule a visit with the surgeon for september 2007. I'm hope to get an appointment sooner.

NURSEDSD · July 13, 2007

Hi I have BC/BS of MA PPO. It was so easy from my first visit till my surgery was 10 days. They required no pre cert or pre authorization. You can go online and look at the medical policy for bariatric surgery at BCBS.com. Good luck. I hope it is as easy for you as it was for me. Banded 6/26/07 I have lost 15lbs in 16 days...Donna

LTjr · July 13, 2007

I just got my approval in the mail today, no sweat. Date is set for August 1st.

There were no hangups, probably because my case is bad. Pre op diet starts Monday....ugh.

babs0101 · July 17, 2007

Congrats! I have Health New England and they require I do a year of supervised diet! Good Luck!

kmg1997 · August 14, 2007

hi there!

i am in Mass too . I just went to my seminar to day at Lahey Clinic. I have BCBS as well and I am afraid that they will deny me. I have a gym membership as well, I have 3 years of weight watchers books to prove i went there and i think i can get a note from my primary care doctor. i think it depends on the plan you have as to if they cover it. have they been giving you a hard time already or are still waiting for your intital approval? i wish you the very best of luck ! i will keep my fingers crossed for you getting approved :wacko:

AngelSoftSnow · August 14, 2007

I was told by the surgeon's office that HMO Blue New England will be fine and that they would get it approved for me. My primary has sent the surgeon a letter stating that she supports me and recommends the surgery. My bmi is 43 and I have a thyroid problem. I can't wait to see what the surgeon would say when I meet with him on 9/27/07. I hope I don't run into any problems.