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Anthem Blue Cross Of California - ***

Hi all. I am going a seminar with Sharp in San Diego this coming Wednesday (which is one of the surgery pre-approval requirements). If I end up having the surgery, it will be with Dr. George Mueller. I have heard great things about him so far, and his VST profile says he accepts my insurance. I was wondering if anyone else has gotten approved with Anthem Blue Cross of California -- I have an ***, but there is surprisingly very little information on my insurance card. Also, if you went through Anthem, did you have to do the six months of supervised dieting? Wondering if my weight watchers tracker will count or if I have to start 6 months over again...

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Does it always *** out H M O?

I have the same insurance. They didn't require a 6 months waiting period. I was approved very quickly for both the Lap Band surgery, and the revision to the sleeve 12 month later (I got approved for revision t 192 lbs). The only things required were a nutritionist consultant, a chest x-ray, and phsyc consult, and blood work. Both times I had my surgery date 4 to 5 weeks after submission. Oh and I also had to write a letter about my dieting history, medical history, and family weight and medical history.

Best of luck!

  • Author

I have the same insurance. They didn't require a 6 months waiting period. I was approved very quickly for both the Lap Band surgery, and the revision to the sleeve 12 month later (I got approved for revision t 192 lbs). The only things required were a nutritionist consultant, a chest x-ray, and phsyc consult, and blood work. Both times I had my surgery date 4 to 5 weeks after submission. Oh and I also had to write a letter about my dieting history, medical history, and family weight and medical history.

Best of luck!

I'm only 25, but I could write a book on my dieting history! Thanks for the info, Lianne =)

Dr. Mueller is such a great doctor. At the seminar he will take the time to answer any and all questions you have no matter how long it takes.I have Anthem BC ppo and I submitted to my insurance last week, just waiting for approval. I have a date of Aug.14th for my surgery. I did not have to do a six month diet. I just had to show that I have tried to lose weight. Good luck.

  • Author

I have the Anthem Blue Cross Classic Select H M O. The sleeve is covered by the insurance, but not with my current medical group. I got assigned to Sharp Rees-Steely (I think because that's the closest to my house?) and that medical group only covers the gastric bypass procedure. Sharp Community Medical Group covers all 3 procedures (lapband, sleeve, bypass), so I'm going to call and see if I can switch over tomorrow, and it should be effective next month... or maybe September... not sure. I'm really hoping I don't have to do the 6-month supervised diet because I've tried and failed so much already -- I just want to get movin' with something that actually works!

I also have Sharp Rees-Steely in Rancho Bernando. I just went in to my doctor and told her about the sleeve, she had never heard of it. She was all for it. I hope all goes good for you and let's stay in touch. I can't wait to be on the losers bench with you and everyone else.

  • Author

Alright so Dr. Mueller has a lady that handles all the insurance. I need to talk to her, but she's on vacation =(

Last night, Dr. Mueller mentioned that Sharp Rees-Steely only covers bypass so I thought no problem I'll just switch to Sharp Community Medical Group. Well, my "Select H M O" doesn't cover Sharp Comm...

My employer offered Kaiser and three different Anthem plans (2 hmos and a ppo). The difference between the two hmos was not clear at all, but I can't do anything about it until open enrollment in November, which wouldn't be usable until January 2013. Lame. I really hope I don't have to wait that long! I'm sure other medical groups within Sharp cover the sleeve... I just need to figure out which one(s)! Insurance lady is on vacation until the middle of next week, btw. Blahhhh. Today was supposed to be productive, dammit!

Insurance stuff can be so nerve racking. Hang in there. Maybe because I have a ppo it's different. The person who you want to talk to is Monique with Dr. Mueller. She is so nice and will help you with anything. I knew she was gone this week. Stay positive and I know sometimes it's hard when it seems like at every corner there is something new to deal with.

  • Author

Yeah I've got Monique's number. How dare she take a vacation :-P lol

I have Anthem *** as well. I'm having surgery Sept 4th at UCSD. I did not have to do the 6 month diet and had full approval in about a week. UCSD does all the evaluation appointments at one time (including phych) so it was pretty painless.

Hilarious. I have Anthem H M O.

  • Author

In case anyone is wondering, I figured out that the Anthem H M O that covers the Sharp Community Medical Group is the "California Care H M O"

  • 4 weeks later...
I have the same insurance. They didn't require a 6 months waiting period. I was approved very quickly for both the Lap Band surgery' date=' and the revision to the sleeve 12 month later (I got approved for revision t 192 lbs). The only things required were a nutritionist consultant, a chest x-ray, and phsyc consult, and blood work. Both times I had my surgery date 4 to 5 weeks after submission. Oh and I also had to write a letter about my dieting history, medical history, and family weight and medical history.

Best of luck![/quote']

Good info.... i have the same insurance and have to write a dietary letter. Are they looking for anything specific to be in the letter?

I wasn't really given any instructions. But I put a lot of thought into my letter. It was a full page typewritten, starting when I was 5 years old. it seemed to do the trick, no one ever questioned me about the contents. I gave starting weights, ending weights, and how quickly I gained weight back after each loss.

O also put a lot of emphesis on the family history of diabetes, and my own medical problems. High blood pressure. elevated blood sugar, severe back problems, stress fracture in my foot, etc. Don't leave anything weight related out.

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