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Blue Cross/Blue Shield PPO


Guest timarland

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Guest timarland

Has anyone had any luck with BCBS PPO in getting lap band approved?

I'm in Illinois.

Thanks!

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I have Empire Blue Cross Blue Shield.It is also PPO. I have not yet been banded, but my Ins. said they do cover the band. I live in Mississippi. I have gotten every thing reqiured by the Dr. and Ins.Co. Med records/ nutritional assessment/ weight loss records/ Letter of medical necesity/waiting to see Psychologist Jan 4. After that I will wait for approval from Ins. Co. You should call your Ins. Co. and ask if lapband is covered. They should tell you right away if it is and how much coverage you would have. Your Band Dr. should be able to send all codes and other health info to them.

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I have BCBS PPO of Nebraska but live in Colo and did not have a problem at all. Prior to seeing Dr. Johnell I even changed my PCP Dr. to be sure she would back me up if needed.

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Not to rain on everyone's parade, but BCBS in Illinois is not the same company as what you have in other states. Every state's Blue Cross is an independent entity, and there are good ones and not-so-good ones.

Is there anyone else from Illinois who has BCBS PPO coverage who can share their experiences?

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I am in St. Louis, MO and I am trying to find an insurance company that will cover the procedure. I have inquired with BCBS on their PPO plan and am still waiting to recieve info pack through the mail. Is there anyone else out there in my area who is doing the same thing? Or cares to share their experience?

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My BC BS policy does offer coverage but I must show a 1 yr history with a Dr who monitored my weight with no improvments. BMI is also a factor and they may still turn me down in the end.

If I go forward with this I will be a self pay and forget it.

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