Jump to content
×
Are you looking for the BariatricPal Store? Go now!
$99 Yearly Supply Alert! 🌈 "1 per Day!" Bariatric Multivitamins

BCBS - What are they thinking?

maryb

By maryb, in Insurance & Financing

Recommended Posts

dpingl    0

dpingl
Posted

AFter reading some of these, I really am wondering if I am REALLY approved. I got a VAGUE letter ALSO stating as follows:

We have completed our review of your request for coverage of LAPAROSCOPIC GASTRIC BANDING under the Yellow Roadway Corporation Benefit Plan. Base o the information reviewed, we are pleased to inform you that coverage is avalible. All covered services are subject to screening for allowable charges.

Its goes on to now that this letter does not guarantee payment etc...??

Does that sound as if I am approved? I have a meeting with my Surgeon TOMORROW, I am excited and nervous!

Share this post

Link to post
Share on other sites

wantlapband    0

wantlapband
Posted

dotofoz,

I decided to go to the doctors office psych. They use the same one. I went to mine first since he has known me for a few years..but he wrote nothing about WLS...it was a general 3 letter that was so impersonal.

I go to day to see the psych.

I'm worried about my insurance carrier BCBS Anthem (nh)...I hope they approve me, the paper work gets sent in after this visit.

Share this post

Link to post
Share on other sites

wantlapband    0

wantlapband
Posted

AFter reading some of these, I really am wondering if I am REALLY approved. I got a VAGUE letter ALSO stating as follows:

We have completed our review of your request for coverage of LAPAROSCOPIC GASTRIC BANDING under the Yellow Roadway Corporation Benefit Plan. Base o the information reviewed, we are pleased to inform you that coverage is avalible. All covered services are subject to screening for allowable charges.

Its goes on to now that this letter does not guarantee payment etc...??

Does that sound as if I am approved? I have a meeting with my Surgeon TOMORROW, I am excited and nervous!

I hope it is an Approval letter! YEAH..keep us posted:)

Share this post

Link to post
Share on other sites

dotofoz    0

dotofoz
Posted

:bandit

Wantalalpband: Well, let me know how the visit goes, I wish you the BEST! I don't think these ins. cos. realize the mental torture they're putting us thru while we have to play their games! Oh btw, is your anthem fep? Mine is.

Share this post

Link to post
Share on other sites

officegirlblues    0

officegirlblues
Posted

Hey everyone. I have BCBS of Alabama and they do NOT cover the band. They will cover gastric bypass any time but not the band. :) I know. Doesn't make sense to me either. I've been trying for over 3 years to get the band and the doctors here won't even file it anymore. I've had one actual denial and I've seen a couple of different doctors and they all say there is no point in filing. BCBS of AL considers this surgery investigational.

I've written to the State Insurance Board and basically what they said was that each BCBS is different. Alabama chooses not to cover it for whatever reason and there is not a whole lot that can be done about it. All of the states around Alabama cover it so we're hoping maybe it will trickle down to Alabama eventually. Unless you have a kind of self-insured BC plan for a very large company you are just out of luck. Frankly, I'm getting tired of waiting and am considering just going ahead and having the bypass done.

Congratulations to everyone that has had it approved.I think its great and I am so happy for you! :clap2:

Hope

Share this post

Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
Go To Topic Listing Insurance & Financing

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
    • KimBaxleyWilson

      KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
      · 0 replies
      1. This update has no replies.
    • bellaamey

      bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
      · 0 replies
      1. This update has no replies.

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    Bariatric Forums

    For Patients

    Health Professionals

    Search Surgeons

    Bariatric Surgeons: Want to research a weight loss surgery surgeon? Enter their last name below to start!

    ×