Insurance issues!!

Mrsace13 · September 30, 2008

The hardest part of all this seems to be the insurance!!

At the seminar I was told BC/BS PPO had the 6 month pre diet and United Health Care does not but you had to have a 40 BMI and mine is 38. So I called BCBS and they mailed me all the info, it does not say I have to wait 6 months so my dr office said I might be able to fight that, who knows.

I did find out that I have a $1500 dec and they pay only pay 75% so I am going to have to pay a lot of money. Does anyone know if that has to be paid up front or is it like when you go to the hospital and then they bill you? If I have to pay it up front then I guess the 6 months is fine since I will need that time to come up with the money.

I called my UHC and they do not cover it AT ALL so they are out.

This is all just too much!! Too much info to learn about, I just want to get approved and be ready!!

mnn2501 · September 30, 2008

I called my UHC and they do not cover it AT ALL so they are out.

I had United Health Care, they covered 100% after my deductable. They required an: exercise evaluation, a psychological evaluation and a letter from my GP stating my co-morbidities (In my case: diabetes and high blood pressure) My BMI was over 50 though.

dovehill · September 30, 2008

Hi, I am just beginning to find everything insurance wise myself. You may want to talk to BCBS again as my BCBS has a little note that if medical necessity you can go w/a BMI of 35-40. Hope that helps. Good luck:omg_smile:

Mrsace13 · October 1, 2008

I had United Health Care, they covered 100% after my deductable. They required an: exercise evaluation, a psychological evaluation and a letter from my GP stating my co-morbidities (In my case: diabetes and high blood pressure) My BMI was over 50 though.

I wish my company allowed it but they have it in there that it is not covered at all. I was pretty upset that they did that. I just left the dr and my BMI from their weight scale is a 39 so I could have had my surgery soon:cursing:

swiley · October 11, 2008

The hardest part of all this seems to be the insurance!!
At the seminar I was told BC/BS PPO had the 6 month pre diet and United Health Care does not but you had to have a 40 BMI and mine is 38. So I called BCBS and they mailed me all the info, it does not say I have to wait 6 months so my dr office said I might be able to fight that, who knows.

I did find out that I have a $1500 dec and they pay only pay 75% so I am going to have to pay a lot of money. Does anyone know if that has to be paid up front or is it like when you go to the hospital and then they bill you? If I have to pay it up front then I guess the 6 months is fine since I will need that time to come up with the money.

I called my UHC and they do not cover it AT ALL so they are out.

This is all just too much!! Too much info to learn about, I just want to get approved and be ready!!

Hello, I have bc/bs of ga. If u are out of network. I was told u have to pay everything before the surgery of or get your own financing. I was also told on the phone I would not a 6 month diet plann, My bmi was 40.7. I learned to call behind the doctors office and double check everything they say. Because to get u in there they will say u are covered and then hit u with u got to pay this and that . But I feel your pain. I started Aug. 12, 2008. I had to go to 2 sleep studies. Now I have to wait till Oct. 30 for my appt. with the doctor. But I am trying to be patient along with being excited about the surgery.I hope everything goes well for you. Try(care credit for medical financing). good luck