Blue Care Network (HMO)of Michigan

[stitchntime 0]

Does anyone have Blue Care Network (HMO)?

What was the criteria for the surgury?

Did you have to do 6months of jumping through hoops and diets or did they just aprove it with weight related health issues.

I have called my insurance customer service and was told yes they cover it if you have : High blood presure, diabetes, of which I have all of them.

She said my doctor would tell me what is the list of requirements.

He didn't tell me, he just said to make an appt for the seminar and then the surgeon. My seminar is 8/18/08. I am excited.

So,,, any info from fellow BCN insurers.

Thanks.....

[bobdole48150 0]

Any update? I too have BCN and I am wondering what I will have to do to get it approved.

[BeautyLocs 0]

Hi--

I see this thread is a couple months old, so you may have gotten your answer. I have BCN and they require a six-month supervised diet program, a psych eval, participation in at least one support group, a letter of medical necessity from your PCP and an EGD. Other tests might be required depending on your medical history. You also have to meet the NIH requirements (e.g. a BMI of 40 or 100 pounds overweight, comorbidities if BMI less than 40 etc.). If you call the insurance company they can send you their written policy.

I know people who have been approved for both gastric bypass and lap band under BCN. I've completed all the steps, but am waiting on the chart from my six-month program to be sent to my surgeon. I'm hoping to have a response from BCN by the end of the year.

Best of luck to both of you,

Beautylocs

[edub 5]

I have an appointment next week with to get the ball rolling on my six month diet and all that.

But, BCN is telling me I have a 50% co-insurance which is odd since my explanation of benefits is for zero co-insurance. Evidently, the fact that I purchased a zero co-insurance policy means nothing since they get to pick and choose which things are not included in my contract that clearly states zero f***ing co-insurance.

What other business' can have a contract that states an agreement plain as day and then unilaterally pick and choose when the contract applies and when it does not?

Can an auto insurance company sell you full coverage and then after an accident claim that they don't cover damage cause by pick up trucks?

Where is the consumer protection when it comes to these criminals? I have it on paper that I have zero co-insurance. I'm no lawyer but last I checked that is called a material misrepresentation or fraud.