Help! Does anyone have Capitol Blue Cross PPO?

[keltokel 4]

I apologize if this is the wrong area to post, please point me in the right direction if there's a better one.

I've completed all my requirements for sleeve surgery under AETNA. The doc was ready to go ahead with my paperwork for pre-authorization, when my husband quit his job and started a new one.

New insurance is Capitol BC/BS of Harrisburg. I know they cover bariatric surgery, but for the life of me, I cannot find the exact requirements.

Our new insurance doesn't kick in until he's at the job for a month, so that will be Feb. 11.

I am trying to decide if I should just pay another month of COBRA and get the surgery done under AETNA, or wait until Feb. 11 and try to get approved with the new insurance. I hate to have to start all over again.

I am a mess with this decision.

My fear is that the new insurance will make me wait another 3 months or so. I only had to do 3 months with AETNA.

Thanks!

[Tobeornottobe 89]

Have you called them? They can usually email you the policy. You wouldn't necessarily have to start over but if the requirement with the new insurance is 6 months, you will have to do the additional 3 months.

I did a quick search and found this: https://www.capbluecross.com/wps/wcm/connect/8c81d245-cf36-42fc-bee7-a19a9a2cf2f8/Bariatric_Surgery_11-2-15.pdf?MOD=AJPERES

I would still call to confirm this is correct.

Good luck!

[keltokel 4]

Thanks. I did see the web site but if you look closer, it doesn't actually give specifics. I did call BC/BS and they weren't much help since I am not in their system yet. My doc thinks I will be OK, and it appears the criteria is pretty much the same at AETNA. Fingers crossed.

[Tobeornottobe 89]

That's such crap. They can give you that information. I hate when insurance companies play silly games.

Good luck!

[sleever13 2]

I have that insurance and had no problem. I started this journey the end of October and was sleeved Jan 7th. Could of went early but my Dr. was on vacation after the holidays. Approval only took 1 day after my final test. I also had a lower BMI

[ReadE4AChange 2]

Is there a specific set of requirements with capital blue? I also haven't found many details.