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BCBS and Unitedhealthcare

i dont even know where to start. i know some people get them to pay for the sleeve but i dont know how. it would be my first wls i dont know if that makes it better or worse. what do i have to do to get them to pay for it. what does the doctor have to do? i feel so lost. empire plan approved but they did not. they did not approve because it is invetigational. how do i show them that it is the best thing for me and that it has been around for a while. this is going to be hard. i dont even know how to research it.my eyes are bad so this will take me forever and a day. if anyone can point me in the right direction i would really appriciate it.

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I called my insurance company myself & discussed WLS with them. I know ins companies can be hard to deal with, but that's your best bet to get started. I found out that my BCBS of TN policy does cover the sleeve, but I wouldn't qualify as my BMI was 34.5...I didn't want to wait any longer, so I self paid.

If you have a surgeon that you are seeing, his/her office should help you deal with the insurance company. They should try everything in their might to get you approved for the sleeve. If they are not trying to help you, I suggest you see about finding another surgeon whose office staff is willing to help you.

Good luck!

UHC used to cover the sleeve but now they don't.

Morons.

  • 4 weeks later...

Alisa--Call BCBS tomorrow and tell them you want to know if CPT code 43843 is covered. I have Federal BCBS and my docs office has called twice. Both times, they have gotten a yes for the answer.

Alisia already won her appeal and is having her surgery today! We are all very excited for her.

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