Blue Cross of Florida just crushed my dreams

[verdalilly 28]

I live in Colorado.... They changed the requirements for my insurance to cover the surgery 3 days before my paperwork was turned in.. I was denied. However my doctor wrote a letter and they approved me based on his letter. Don't give up hope. Good luck

[Nurse 52 94]

^{I'm so sorry mine was not covered through my job BCBC of Tennessee so the Bariatric Dr I saw told me about Mexico because I was crushed my PCP agreed with him co im having mine July13. Good luck to you:)}

[stuart85 28]

Just curious, did you actually look at your benefit plan before going through all that? I knew my insurance coverage before I even started.

No, I did not, I trusted the doctors office that called and was told by BCBS that it was covered, when is dealing with an insurance company ever easy and to go through my benefits book, if I knew where it was, wouldn't have been easy either, why I figured the office knew what they were talking about when they said yes, it was covered.

[stuart85 28]

I barely feel comfortable having the surgery done in my town, let alone having it done in a foreign country a couple thousand miles away where nobody speaks english, may as well have the surgery in Florida would be the same thing, HA! I don't know if I mentioned this I am in NY, not Florida where my policy is, as I am a Florida resident, not a NY resident.

[Nurse 52 94]

That's crazy the same with me mine is BCBS of Tennessee and I live in Az.

[gigito2 52]

Yeah - I have BCBS of Mass - and I live in NY!

[Bobbe Schu 53]

Yeah - I have BCBS of Mass - and I live in NY!

What happened?

[Nikasio 59]

Medical Tourism is big business in Mexico. Check some of the links on this site and you will be surprised how many doctors and staff are bilingual. When it comes to Medical Tourism, English is the lingua franca for services. Several of my American born doctors studied abroad, whether it was Guadalajara, Grenada, Italy or Spain. As for affordable care act issues, the compromise for what individual states consider essential health services was to appease states with low levels of acceptable public services. A lot of compromises were made and the winners were the insurance companies. When I was a kid in Florida I use to hear horror stories of uninsured people being discharged from hospitals as soon as they were stabilized.

Edited June 10, 2015 by Nikasio

[gigito2 52]

Nothing yet, Bobbe - my surgery won't be until Sept or Oct - just hoping it will be covered.

Was really commenting on the vagaries of the ins co's. Stuart lives in FL but has BCBS of NY (or vice versa). Kiki lives in AZ but has BCBS of Tennessee.

No wonder people have a hard time figuring out if they're covered - and that includes the MD offices, too.

Sorry if I added to the confusion.

[Sharon1964 2,530]

Here is a table by state of coverage for weight loss surgery under the Affordable Care Act:

http://nofusa.org/news/health-insurance-cover-obesity-treatment/

There is also other information about financing and coverage. The state of NY offers bariatric surgery as part of the ACA. Perhaps a move to NY since you are there already is in order?

[stuart85 28]

Here is a table by state of coverage for weight loss surgery under the Affordable Care Act:

http://nofusa.org/news/health-insurance-cover-obesity-treatment/

There is also other information about financing and coverage. The state of NY offers bariatric surgery as part of the ACA. Perhaps a move to NY since you are there already is in order?

One would think the drs office would know that website, as I'm sure I'm not the first one from out of state to want coverage ...

Thanks

[hikergirl14 80]

Why don't you switch to the NY coverage. I lived there and never formally changed residency from Florida and was still able to get insurance, plus didn't have to pay a dime since I made under $90,000/year with a family of three. This was before the Affordable Care Act. Try and see if you can change insurance companies. Plus NY covers bariatric surgery.

[SookieLei 47]

I went through this whole bariatric process a year ago, lost my job so of course lost insurance. I looked into obamacare and while some states DO cover it, there are a handful who DO NOT. I know its disheartening, I'm sorry.

[stuart85 28]

Why don't you switch to the NY coverage. I lived there and never formally changed residency from Florida and was still able to get insurance, plus didn't have to pay a dime since I made under $90,000/year with a family of three. This was before the Affordable Care Act. Try and see if you can change insurance companies. Plus NY covers bariatric surgery.

They verify you are a NY resident now so I can't just get a NY policy

[kimby1029 119]

I am so sorry this happened to you. I had to self pay for my surgery since I am a state employee in Texas and Scott and White insurance will not cover it. It is insane that the Scott and White Hospital is a Bariatric Center of Excellence and has excellent surgeons, but they will not cover the surgery. They do accept other insurances, but I cannot just switch insurance mid stream, have to wait for enrollment, which would not really help me. I know how you feel.

Can you maybe get a low interest loan to do self pay? They typically will do a special rate for self pay patients. I do not know the cost in Florida, but Texas is (fairly) reasonable about 6-15K depending on where you have the surgery.

Hang in there.