Yikes, in July changing insurance companies!

[BabyNicole 0]

I'm a teacher, and we currently have Oxford. As of July 1st we will be going to BCBS. When I go see the surgeon next week I'll have to make sure that my surgery is in June. I hope that's doable. I don't know what plan we will get with BCBS and I don't want to have to wait 6 months doing preop God knows what b/c Oxford is easy!

[pta2007 3]

Have you already been approved with your existing insurance company? If yes, then how do you get your fills when BCBS takes over? I would check with BCBS to see if your surgery and fills will be covered with them. It might be worth the wait if they cover both, so you don't have to pay out of pocket for your fills when you lose your existing coverage.

Just a thought.

[Linda Lu 1]

I had the same dilemma haing been approved by Harvard Pilgrim in November 07 and finding out my company was switching to BCBS Jan 1, 08. I lost the required amount of weight preop and was able to be scheduled for surgery the day after Christmas with the insurance company that had approved me. There has been no problem with BCBS picking up the cost of the fills; I jus get billed a co-pay like any other office visit. And...I love my band!! I've lost 73 lbs since starting the preop diet! Best of luck to you!

[Boo Boo Kitty 3]

I'm a teacher, and we currently have Oxford. As of July 1st we will be going to BCBS. When I go see the surgeon next week I'll have to make sure that my surgery is in June. :biggrin: I hope that's doable. I don't know what plan we will get with BCBS and I don't want to have to wait 6 months doing preop God knows what b/c Oxford is easy!

Good luck to you! If I were you I would make it clear that it HAS to be done in June or you will be going somewhere else. That should help them make sure you get it done then. Money is a great motivator ya know!

Good luck!

[BabyNicole 0]

Have you already been approved with your existing insurance company? If yes, then how do you get your fills when BCBS takes over? I would check with BCBS to see if your surgery and fills will be covered with them. It might be worth the wait if they cover both, so you don't have to pay out of pocket for your fills when you lose your existing coverage.

Just a thought.

No, I haven't been approved yet, but with Oxford if you have a BMI of 40+ no medical direction is required. So I have no doubt I will be approved. :biggrin: That would stink, though if BCBS didn't offer fills!

[MacMadame 81]

I'm in a similar boat. My current insurance excludes WLS but my company has other plans with other companies that cover it. So I'm thinking about switching during open enrollment.

But switching in the middle really throws a monkey wrench into things. The surgeon consult is expensive so you need to wait until you are covered but then they want you to lose weight. I want to start losing weight now but if I start now, I'll probably get too low a BMI to be covered. If I wait until Aug., I'll be having surgery in the middle of the holidays -- a time I really need to be at 100%. By Jan. things are crazy at work so I'll miss my window and have to wait until Fall '09.

Obviously, I'd rather not do that. :biggrin:

I'm really seriously thinking about Mexico again. I'd rather get it done locally as there are several excellent surgeons here but these hoops I have to jump through are driving me crazy.

I don't have a problem with the pre-op requirements. I'm happy to go through any pre-op program or do any pre-op testing that is required. It's the phone calls to insurance where you get a different answer every time and not being able to control my own destiny (even more than normal when it comes to the US health system) that is driving me batty!

[BabyNicole 0]

I had the same dilemma haing been approved by Harvard Pilgrim in November 07 and finding out my company was switching to BCBS Jan 1, 08. I lost the required amount of weight preop and was able to be scheduled for surgery the day after Christmas with the insurance company that had approved me. There has been no problem with BCBS picking up the cost of the fills; I jus get billed a co-pay like any other office visit. And...I love my band!! I've lost 73 lbs since starting the preop diet! Best of luck to you!

I will tell my surgeon when I see him and ask their insurance person how BCBS works here in Jersey. Wish me luck!

[BabyNicole 0]

I'm in a similar boat. My current insurance excludes WLS but my company has other plans with other companies that cover it. So I'm thinking about switching during open enrollment.

But switching in the middle really throws a monkey wrench into things. The surgeon consult is expensive so you need to wait until you are covered but then they want you to lose weight. I want to start losing weight now but if I start now, I'll probably get too low a BMI to be covered. If I wait until Aug., I'll be having surgery in the middle of the holidays -- a time I really need to be at 100%. By Jan. things are crazy at work so I'll miss my window and have to wait until Fall '09.

Obviously, I'd rather not do that.

I'm really seriously thinking about Mexico again. I'd rather get it done locally as there are several excellent surgeons here but these hoops I have to jump through are driving me crazy.

I don't have a problem with the pre-op requirements. I'm happy to go through any pre-op program or do any pre-op testing that is required. It's the phone calls to insurance where you get a different answer every time and not being able to control my own destiny (even more than normal when it comes to the US health system) that is driving me batty!

The surgeons that I go to hand ALL the insurance mambo jumbo. They even file appeals for you and hire a lawyer for FREE! :biggrin:

[BabyNicole 0]

Good luck to you! If I were you I would make it clear that it HAS to be done in June or you will be going somewhere else. That should help them make sure you get it done then. Money is a great motivator ya know!

Good luck!

Trust me, with my big mouth, they will know! :biggrin::lol: BTW, you look GREAT up top!

[Boo Boo Kitty 3]

Trust me, with my big mouth, they will know! :biggrin::smile: BTW, you look GREAT up top!

As they should know!

Thanks.