Self-pay question

[suzycooke 0]

Hi all! I had my first consult yesterday and got the ball rolling! I'm a self-pay patient (Thanks Blue Cross Blue Shield!) and was wondering if any other self-pay bandsters were able to get their insurance to pay for any of the pre-surgery tests. The nurse practitioner said to put the insurance card out for each appointment and at least see if BCBS will cover any of them.

Thanks!

Suzy

[Shar Pei 0]

I am self pay and I have gotten a portion of the testing paid for! Good luck!

[suzycooke 0]

Thank you! Good luck to you as well!

[Lap Band Gal 41]

I got my insurance (Aetna) to cover the psych eval...that's it though

[Soexcited 64]

I am 100% self pay ... the bill's a zinger!

[marmar 0]

with my lapband Dr.s permision I just had my family dr rewrite the lab work and things and my ins payed for all the tests.

[AbbeMac 0]

Im new here today. I can't understand what you're asking. My BCBS has covered all testing and I fully expect them to cover the procedure as well. What type of Blue Cross do you have? I have BCBS Minnesota, PPO.

[marmar 0]

most ins company have different plans. The employer chooses what plan to get. My hubby has Cigna and cignas plan A covers the surgery. Well his plan through his employer is the B plan and that plan doesnt cover it. Call your ins. to see if the plan you have covers it before you go ahead and do anything.

[ParrotheadCathy 0]

Suzy, my Blue Cross Blue Shield policy had a written exclusion against any weight loss surgery, so I know how you fee! I weighed 284 pounds, had 3 comorbities and my PCP supported my choice 100%. So I went to the first visit, found out what testing had to be done and then called my PCP. He made referrals through BCBP docs for everything i needed, had the results sent to him and he sent on to my surgeon's office. Other than a couple of $25 co-pays, the pre-op testing didn't cost me anything really.

Abbemac ... be aware that it is NOT the insurance company who is telling you they won't pay for it. It is the employer who negotiates with the insurance carrier as to what they can provide for a price. So some of us have coverage for WLS and some of us don't. I have BCBS HMO...and a written exclusion put it by my employer and you can't even appeal a written exclusion. But my best friend has BCBS HMO too ... and her policy covers WLS with just a couple of qualifications. But all that testing that you have to do before surgery is pretty much stuff that tests for problems any obese person might suffer, so to go back to your PCP and get referrals to docs for the testing is a very smart thing to do if your policy doesn't cover the surgery.

[skinny2Bme 0]

I was just banded Sept 22. I have not had my first fill, yet. My insurance has a clause that they do not cover any procedures for obesity. To make sure my ins covered the labs, I had my family doctor order the lab work and then I sent a copy of the results to the bariatric doctor. If the ins knew that it was for a bariatric Dr, they would not have paid. Doing it this way, they paid for the lab work. However, I did pay for the psych evaluation. I did not want that on my insurance record.

[SmilinShel 0]

I did what the other posters have said. My family doctor ordered all my labwork and coded it so it would be covered.

I also had to have a hernia repair during my surgery, so the surgeon's office is in the process of getting BCBS to pay for a percentage of the OR, hospital stay and anesthesia costs. If you have any other covered procedure done at the same time, they have to pay for the appropriate portion.

[suzycooke 0]

Thanks for all the great information! I appreciate it! Bariatric Treatment is excluded on my policy for BCBS, but hopefully I can sneak a few of these tests by them by doing what y'all have suggested.

Thank you again!

Suzy

[ncarreras 0]

Hi,

I have the same insurance and I am self-pay. They covered all my pre-op visits including the consult with the surgeon and the bloodwork. Good luck!

[Danyett 0]

I am 100% self pay. My ins. covers 0% for WLS. My Doctor has a set price for surgery and everything else is included in that price.

[kiz 1]

My self pay fee included everything except the psych eval. I chose to pay that out of pocket, because I didn't want to have it on my insurance record. The surgeon's office gave me a list of psychologists to chose from, and their fees varied by several hundred dollars. One only charged $100, and if I remember right, some of the others charged as much as $500. Needless to say, I went with the $100 doctor.