Question

[TammyL 0]

Hello Everyone! I am considering have the Lap Band surgery done. I go to the informational meeting on the 23. From what I have read so far, it seems that Blue Cross Blue Shield covers the surgery. Does anyone know if Blue Choice HMO (a branch of Blue Cross Blue Shield) covers the surgery as well?

[TexasFire 84]

Hmm...good question! I don't know if I just got "lucky" or if this was typical, but all the offices that I considered handled that process for you with a quick turnaround. (My coverage was verified with BCBS in one day!) If they found out my insurance would cover it, they would handle the approval process, as well. It can be a bumpy road sometimes, going through approval process...but they should make it relatively painless for you. (Aside from the grueling waiting, of course! Nothing can make that go away!) Good luck! It's a great tool!

[Ellisa 6]

It depends on whether or not there's an exclusion on the policy. Call the number on the back of the card and ask if weight loss surgery is covered on your policy, specifically lap band surgery.

Once you find that out, then look for a surgeon and facility that is in network for the HMO.

I have Anthem BC/BS PPO, and there was no exclusion. I found a surgeon who was in network (at the time, he isn't now) and it was approved.

[TammyL 0]

Thanks for the help!!!

[Sici7805 0]

I have the BCBS HMO, went to see the surgeon, completed the paperwork with him and then received a call from the surgical coordinator telling me that the 6 month supervised diet was required along with a mental eval. I am getting the impression that this is a " canned response" from the office and they did not even submit anything to insurance. My insurance company told me that surgery was covered but did not mention any conditions. I have not received anything from the insurance denying the surgery. I have a BMI just under 40 but I am diabetic. I thought I would be approved without any issues. Anyone have the same experience?