Quick approval - BCBS CA

[chrisgtl 0]

Hi All,

This is my first post. I received a very quick approval for Lapband last week. The doctor's office submitted request on Monday and by Wednesday it was approved. I have a surgery date of May 31st.

Ready for this journey

Chrisgtl

[disneynut 0]

Wow, that was fast! Congratulations on your journey.

[JanetC 2]

Wow, that's awesome!! Welcome to LBT & congrats on your approval & date! Ask tons of questions & read all you can! We're glad you're here!

[maryb 1]

My best friend was able to get insurance approval from BCBS- CA in three weeks. Her insurance is CA even though she lives in TX. She was told that BCBS -TX doesn't pay for the surgery.

[Poodles 0]

I have BCBS-TX TRS Activecare and they approved me for lap band. :bananadoggywow:

[3loves 0]

Congratulations!! That is amazingly fast and I'm so happy for you. Your date is on my birthday. :biggrin1: BTW, welcome to LBT, we're glad your here!!

:welcome2:

[nutmeg1965 0]

Did you have a high BMI and any comorbidity issues to argue your case. I have BCBS in MO. Just looking into Lap band myself.

[Vera 7]

Congratulation on the approvals!

You really have to read you policy carefully. I have BCBS CA and it is not covered.

[chrisgtl 0]

My BMI is 48.2, I have sleep apnea, hypersomnia (excessive daytime sleepiness), I've had high blood pressure. I think other contributing factors were health issues of siblings.. One sister with diabetics, sleep apnea, 2 sisters obese.

I think the way the doctors present information to insurance companies is key also. Mine had a letter of recommendation from my primary doctor, my sleep study results, a pychic evaluation and long term documented efforts to loss weight on my own.

[desperate 0]

What kind of BCBS policy are you under?

[chrisgtl 0]

Blue Cross EPO (outside California) - The company I work for is based in California, but I live in Kentucky.

[beachgirl 2]

Hi,

I'm new here and I was just reading your post. I too live in Kentucky and I have Anthem which is BCBS Anthem. Do you think they will approve me? I didn't know if it was the same or not. If insurance won't cover I'm going to Mexico. Does my doctor call my insurance or do I.

Hope you can help me,

Thanks in advance,

Sherri in Kentucky

[ralheit 0]

I was approved in Ohio with Anthem BCBS. It only took 3 weeks after I had waited almost a year with Medical Mutual.

[chrisgtl 0]

There's no way of knowing if you're insurance is going to cover procedure until you've started the process with a Doctor. Key to my approve was all of the pre-paperwork and information the doctor required before they'd even send in my claim.

Before sending information into insurance for approval I had to have:

A nutritionist eval

A psychologist evaluation

A referral letter from my primary care physician

All of my sleep study reports

An evaluation from surgeon on my situation that outlined all of the conidition I had as a result of obesity.

When I called before all of this information was gathered my insurance company said I wasn't unless to treat morbid obesity, which I didn't need all of the information above to tell me I was, but the insurance company did.

I think it's worth your time and effort to start the process to find out if your insurance company will pay for it. There are so many different policies-there's just no way of knowing until you get all of the information submitted to them to review.

Good luck!

[Yvonne2 0]

Hi there-

I see you have BCBS EPO......I have called my BS EPO twice and received oposing answers concerning Lapband coverage. I have this insurance thru my work here in California. I was discouraged after the last call but guess I will continue with the required psych and nutrition assessments. Maybe there is hope since you were approved so quickly!

Good luck to you next week Chrisgtl.