Blue Cross MA PPO

kswinterk · November 24, 2008

So I am going to my seminar on Decemeber 1st to start the process of getting my surgery. I was curious if anyone had Blue Cross MA PPO insurance that can tell me what they had to go through to get approved. Thanks for any adivce given.

thinkingaboutit77 · November 27, 2008

Hi, I'm in Ma and have the same insurance. I'm curious too. I just went to a seminar last night, still on the fence about the whole thing, which is why I'm on this site, to learn more. I would love to hear any info you may have. Do you have a doctor chosen yet?

needtoseemeagain · November 27, 2008

I have Blue Cross PPO, but not in MA, however you can read medical policies on their web site, and it will have the criteria used to authorize procedures. Also, in my state we have to go to a Center of Expertise, a Participating provider is covered at a higher benefit level. If BMI 40 or over ussually can be approved but you should review your specific plan criteria.

kswinterk · November 27, 2008

I called my insurance the other day and they said pretty much you have to have a bmi of 40 or 35.5 with one of the 6 critera. I was more worried about having to a six month dietician diet and they said that was not in the regulations. So I am going to my seminar on monday and I am going to start the whole process and see what happens. I have a 39.9 BMI with stage one of hypertension that I have had since I was 16. I am now 27 and I have proof that I have been on mediciation since then.

Bobbie155 · November 27, 2008

I have Blue Cross PPO in Pennsylvania and I had to to see my pcp for 6 straight months, have a psyc eval and meet with the dietician. I also had to have a bmi of 40 or above. If you had a bmi below 40 you had to have other problems like gerd or sleep problems. After all the paper work was sent in it took them about 36 hours to send an approval to my Doctor. Then I was on my way.