keystone health plan east/bcbs of philadelphia

dawn7672 · September 11, 2008

Has anyone had difficulty getting approval? this is my insurance. it is a ppo just curious if anyone has had trouble getting approved.

TIA

Dawn

HelloPitty · November 4, 2008

Hey i just applied to Keystone Health Plan East - HMO. Didnt get an answer yet for coverage let alone the surgery. Did you apply yet?

dawn7672 · November 5, 2008

No not yet. My chart will be faxed over to the surgeon on the 10th of the month, I have one more pre-op class to take and my chart (pre-req ) will be complete. I was told to check with the surgeon or ins. company after 10 days once chart has been submitted. Let me know how you make out. I think I'm getting a little nervous about whether I will be approved or not.

Dawn

HelloPitty · November 6, 2008

Wait - What's the pre req stuff? What are your stats? Im 205 5'3 with a bmi of 36.3. I know Im lower than some people that Ive been reading about but I feel I really need this surgery. Im nervous too about being approved. Someone gave me the name of a doctor from the barix clinix in Langhorne. She she got the insurance and then was approved for the surgery 7 days later, she didnt have to do any thing her doctor did it all! No diets, no paperwork, no nothing. So Im gonna make an appointment to see him. As soon as I get approved for this insurance.

dawn7672 · November 7, 2008

I had to have an ekg, lab work, psych consult, sleep study, and nutrition classes. And in south Jersey, the doctor and hosp. have a program called new beginnings, and we have to join the program prior to paperwork being submitted to the ins. co. If your insurance requires a 3-6mon diet, this program will assist you with that and report back to ins. co how you are doing. It also provides support groups for you as well. I enjoy the program very much. I have completed all but one class, which I take on Sat. and then my file will be sent to the ins. co. I also needed to get a history of previous attempts at wt loss in the last 5yrs. Hopefully, I will know something by Dec. I would love to get it done in Jan.

My highest wt was 260, I am currently 235.4. When I met the surgeon I was 247 and he req. me to lose 10lbs. I have met that goal. I am 5'4. Bmi is around 40.? I would love to be around 150. So, hopefully all works out well.