Anthem

[mch080208 6]

I went for my first appointment about a week ago. Had the majority of the testing required for insurance. When I met with the patient coordinator she told my my insurance required 4 months of nutrition and exercise counseling. I thought it was 6 months (I have Anthem BCBS). Does anyone else have Anthem? What have you been told?

[CRose_RNY 2]

Same insurance here and was told no monthly work ups. I immediately started questioning it... I know there are different plans and all but I've read plenty of forums with the same insurance in my state and they ranged from 3-6 months so I think its possible that you might just only need 4 months. In my case, I went ahead and called the insurance after a 30 min wait but of course, no straight answer. So what my program is going to do is send all the paperwork to insurance for the approval process and then we'll "find out". Which is stressing me out because I don't want to waste time waiting for an approval just to be told that I needed the 6 months of work up. I just left my appt with the Dietitian and she recommended that I start the monthly work ups with the nurse without waiting for insurance approval so that way I atleast have 2 months or so down and if I get approved anyways I would have just added another supporter within my program. I have some blood work to do then a wait game for insurance approval

[mch080208 6]

When I emailed Anthem, they told be weight loss surgery is not a covered benefit. I know this is not true as my friend and co-worker is the bariatric coordinator at another program. I guess I'll do the same and see what happens when time to submit. If I need 2 more months then so be it.

[jess9395 5,449]

Not all anthem blue cross are the same different employers or marketplace plans cover different things even if they are all anthem blue cross, and any employer or group can specifically exclude weight loss surgery or have their own pre op requirement.

[pattycaketoo 133]

Not all anthem blue cross are the same different employers or marketplace plans cover different things even if they are all anthem blue cross, and any employer or group can specifically exclude weight loss surgery or have their own pre op requirement.

I have this, I live in Texas and they required me to do six months of NUT classes with the first visit not counting so I had 7 months.

[mch080208 6]

I guess I'll just wait and see. I've had sooooo many conflicting answers between insurance, coordinator and friends. If it happens, it happens

[jess9395 5,449]

I guess I'll just wait and see. I've had sooooo many conflicting answers between insurance, coordinator and friends. If it happens, it happens

Ask for a copy of your plans benefits in writing

[jess9395 5,449]

I guess I'll just wait and see. I've had sooooo many conflicting answers between insurance, coordinator and friends. If it happens, it happens

Ask for a copy of your plans benefits in writing

[focusonthefuture 14]

I think Jess is on point. I would imagine all doctors offices have someone on hand to do the prior authorizations. Mine has a dedicated person. That person is used to hearing plenty of "no's" from the insurance companies and knows what pieces of documentation or hoops you need to jump through. Example of documentation for me was six months of medically supervised weight loss (though with a doctor or PA, not a nurse), and example of a hoop was having a barium swallow because of my high BMI. These were done and surgery approved.

[SugarSkull 2]

I also have Anthem and was told 6 months. Then about a month to clear me for surgery. Hope you are getting somewhere, insurance is a tough business!

[jess9395 5,449]

My anthem plan didn't require anything except documented attempts to lose weight. I've had the same primary care for years and we've talked about it for years and that counted. Weight watchers records or anything like that would have as well.

[zallykatz16 56]

I have Anthem and I was told 6 months with a doctor or program before they will approve surgery. I hope that I don't have any issues because they can not send in the paperwork until 1 month before surgery here in California.

[Losing in NWAR 21]

I have Anthem. 6 months of appts with the first included. The only extra thing they required after my last appt was a letter of support from my PCP. I got approved last Friday and am scheduled for the 9th.

[gelyscomet 7]

I have Anthem as well, 6 months included 1st appt with surgeon, 4 monthly nutritional classes, 6 month meet with surgeon again (this Wednesday) to see if I'm a sleeve or gastric bypass candidate.

[zallykatz16 56]

I have Anthem also. I just got approval for my gastric bypass. I had to get multiple letters from my PCP and go through a checklist of tests before I could be approved.