Bliss Insurance?

[Susan 2.0 278]

Any self-payers purchase the BLISS insurance coverage? What can you tell me about it? Did you opt in for higher/more coverage?

[LaBelle509 326]

I absolutely did! it covered me for up to 90 days in case of complications. I was so worried that something would come up and be denied coverage by medical insurance. My doctor told me not to take the stricture coverage. It was going to cost me an extra $250 but he assured me I did not need it. I trusted his judgment. I paid the extra $1,151.00 for the BLISS and I was happy to know I could use it, but never had to. Total cost for my surgery was $13,651.00

[Susan 2.0 278]

Thank you for the great info!!

Anyone else?

[jennyannk73 20]

Thanks for asking, I had the same question. I see we have the same Doc as well.

[Susan 2.0 278]

Jennyannk73:

I had other questions so I sent a list to Tammy. She forwarded to Blis:

-----Original Message-----

From: Billie Shellist [mailto:billie.shellist@bliscompany.com]

Sent: Thursday, August 30, 2012 12:34 PM

To: Beck, Tammy

Subject: RE: Blis Insurance questions

Hi Tammy,

Here are the responses to these questions. I'm also happy to speak with this patient directly if you need me to, just provide her with my contact information. Best, Billie

Q: Does the basic ($203.41) coverage include any gall bladder problems which might arise during/after WLS (considering my current health insurance may deny coverage due to the specific WLS exclusion)?

ANSWER: BILS Protection does not cover gall bladder problems following a bariatric procedure. Unfortunately it is not a covered complication for us)

Q: What exactly does the basic ($203.41) coverage include?

ANSWER: The only thing that package C covers (which is your basic package for $203.41) is 90 days of protection for stenosis/stricture. It does not cover any other types of complications.

Q: What exactly is "stenosis/stricture" that is listed as the basic coverage?

ANSWER: Stenosis/Stricture - a narrowing or constriction of the diameter of a bodily passage or orifice. This is most common in procedures that

rearrange your digestive system such as gastric bypass surgery and vertical sleeve gastrectomy procedures and results from a build-up of scar tissue between your intestine and your reduced stomach or at an intestine-to-intestine connection (anastomosis).

Q: Since I live in Raleigh, will the Blis insurance only cover issues/time with Dr. Heider, or would I be able to see a Blis surgeon in Raleigh (if there is one)? If there isn't one in Raleigh, would I be able to be seen in an ER or dr's office here for an emergency need, or would I be required to return to Dr. Heider?

ANSWER: Any complication related care needs to be authorized by the original BLIS Surgeon. This basically means that if you are in Raleigh and having some symptoms you are concerned about, you would need to call Dr. Heider's

office and follow his recommendations. If he decides your symptoms are acute and that you need to go to the ER in Raleigh, you would go there. Dr. Heider would call BLIS and notify them. BLIS would reach out to the admitting hospital and let them know BLIS will be taking care of the bills. BLIS does not currently have a contract in place with any facility in Raleigh. All complication related care MUST be approved and authorized by the surgeon ahead of time.

Q: Would the answers to any of these questions change if I were to choose packages A & B in addition to the required package C?

ANSWER: Each package of protection is available individually and covers a different set of covered complications. If you want more protection for other types of complications besides Stenosis/Stricture, you would need to

enroll in the other packages. Ex: Package A covers you for 90 days for the group of complications we call Cardiopulmonary/Thromboembolic - things like

problems with anesthesia, blood clots, etc. The price of that package is $514.58. Package B covers you for the following covered complications:

Bleeding, Infection, Leak, and Perforation for a cost of $1,293.99.

Basically to get full protection for all the covered complications for 90 days, you would want to enroll in the combination of packages A, B, and C

for a total price of $2,011.98

[jennyannk73 20]

Thanks for the info!