found out bcbs michigan

Eileenlpn · February 29, 2008

I live in michigan and have bcbs, I went to barix treatment center in ypsilanti becuase my insurance company said I did not need pre authorization. I had the consult everything sounded great, my BMI is 46 without any other issues but the DR said I automatically qualify and they have a contract with BCBS. I get ready to leave and this consultant comes in and hands me a practice letter and it reads that you must get your family dr to say you have been dieting for 6 months medically supervised, well shoot I have been dieting on my own so now im back to square one and have to wait 6 months and document it.He said it would definatly be a go, so im thinking this will give me time to really make sure this is what I want. Kinda disappointed but maybe it will give me time to think it through.

demsvmejm · February 29, 2008

I had absolulutely no problems with my approval with BCBS of MI.

I have always had regular appointments with my Primary Care Physician. (high blood pressure & stroke) even though he never "officially" put me on a diet.

He had no problem writing the letter to BCBS about my weight loss attempts, even thought they weren't medically supervised by him..I was instantly approved with my BMI and co-morbidities all taken into account.

I think that was the key...I have seen the same Dr. for almost 20 years and he has seen 1st hand my struggle with weight.

I basically walked into his office and said this is what I want to do, you need to write a letter to BCBS, and he agreed.

nazzy · November 7, 2008

hey all i have bcbs michigan,does anyone know how much the fills are?wonder if any are covered?lmk plz thanks

vzghj3 · November 8, 2008

hey all i have bcbs michigan,does anyone know how much the fills are?wonder if any are covered?lmk plz thanks

Nazzy, Yes BCBS covers adjustments. The best thing to estimate your out of pocket expense is to find out what your doctor will charge for adjustments. Then it will also depend if the dr. is a BCBS provider. The doctor I see is a BCBS provider and charges $200 per adjustment. The BCBS covered rate is $107.50, which they will pay 80% of and I then pay the other 20%, which is $21.50.