Just got Approved it only took two days!!!!

What copay are you talking about?

When I spoke to an insurance specialist, she stated that bcbs instated a 5000 copay in 2011 for all weight loss surgeries. She said some doctors waive this. I was just wondering if this happened in your case. For me, it would mean paying 6-7000 versus 1000 for the surgery! Big difference!!

I was never told anything about 5,000 they just had me pay my hospital fee and their dr fee which came out to be 1,345!

I am so glad to hear this - I should be submitted to BCBS the first week of April!

I have BCBS Federal and they approved it in 1 day! I was in such shock. My first reaction was I am not ready. I got a letter from BCBS Sat and they said my surgery was approved for April 29. I haven't heard my date yet from my bariatric office. What? BCBS is getting very efficient.

I agree it is the best. I had my surgery 12/4/12. First saw surgeon on 10/24/12 and was approved in like 5 days. As for deductable mine was 3000.00 but Dr. Kim has it where no one pays over1500.00 out of pocket. I ended up paying 976.00 total.

I have BCBS of TX and the hospital made me pay $2150 before they would go any further. Doctors office hasn't given me any ideas on how much Doctor's portion will be also had to give the anesthesiologist a $250 deposit. I was willing to do whatever it took to have this surgery. I had to take a loan and borrow money from family but I got what I needed up front and now it's done so guess ill see what happens when the bills start rolling in.

Paperwork submitted today. Waiting begins. Surgeons office said blue cross could take 2-3 weeks to respond. I hope not that long. I have to pay the surgeons fee of a whopping 360 bucks without hernia repair or 560 with hernia repair. I can't complain about that price. Wish me look for approval.

I too have BCBS/TX. I called the surgeon today (who I had the lap band through) but the girl answering the phone acted like it is up to me to figure out if my insurance covers it. Now what? I have no idea where to start !!!

I too have BCBS/TX. I called the surgeon today (who I had the lap band through) but the girl answering the phone acted like it is up to me to figure out if my insurance covers it. Now what? I have no idea where to start !!!

I called the customer service number on my card and asked if the plan my employeer had covered bariatrics. They told me exactly what procedures they did and what the criteria was to have the surgery. They explained the financial portion also. They also told me after I met all the criteria and the surgeon submitted paperwork for predetermination it would take about 5-7 days to get approval. Very smoothe process so far.

I called the customer service number on my card and asked if the plan my employeer had covered bariatrics. They told me exactly what procedures they did and what the criteria was to have the surgery. They explained the financial portion also. They also told me after I met all the criteria and the surgeon submitted paperwork for predetermination it would take about 5-7 days to get approval. Very smoothe process so far.

I wish the customer service rep. would have been a little less vague and told me more on the phone! I am curious what the criteria is. I guess I should call my surgeon's office back and tell them what I have found and see what to do next.

I wish the customer service rep. would have been a little less vague and told me more on the phone! I am curious what the criteria is. I guess I should call my surgeon's office back and tell them what I have found and see what to do next.

I would try calling the insurance back and hopefully get some good "customer service" this time. Your insurance carrier has the specifics of your plan and your surgeons office does not. I think if you get the right agent at blue cross all your questions could be answered for you. i know it can be nerve wracking especially when someone is not giving you vital information, but hang in there and keep pushing you way to sleevedom.

I agree - keep calling until you get someone that will help you. They know the info - but customer service isn't always the priority....eventually you will get the right person on the phone to help you.....maybe a litte sniffle and tears will help! LOL

Wow everybody.....so I was just told by my surgeon's office that I would have to gain 25 MORE POUNDS before they will even send off the forms to try and get me approved by insurance. Never in my life have I ever been told I needed to gain weight. EVER! Apparently because I can't check any of the little boxes off on the criteria for what they feel you should have to be worthy of this surgery. HMMMM now I am in a very interesting situation. What in the world is that going to do to me mentally. Also, I am assuming that I still may not get approved even after gaining the 25lbs and having the 40 and over BMI. WOW.....a lot to think about.........

Wow everybody.....so I was just told by my surgeon's office that I would have to gain 25 MORE POUNDS before they will even send off the forms to try and get me approved by insurance. Never in my life have I ever been told I needed to gain weight. EVER! Apparently because I can't check any of the little boxes off on the criteria for what they feel you should have to be worthy of this surgery. HMMMM now I am in a very interesting situation. What in the world is that going to do to me mentally. Also, I am assuming that I still may not get approved even after gaining the 25lbs and having the 40 and over BMI. WOW.....a lot to think about.........

Where is the dislike button for this?????

Wow everybody.....so I was just told by my surgeon's office that I would have to gain 25 MORE POUNDS before they will even send off the forms to try and get me approved by insurance. Never in my life have I ever been told I needed to gain weight. EVER! Apparently because I can't check any of the little boxes off on the criteria for what they feel you should have to be worthy of this surgery. HMMMM now I am in a very interesting situation. What in the world is that going to do to me mentally. Also, I am assuming that I still may not get approved even after gaining the 25lbs and having the 40 and over BMI. WOW.....a lot to think about.........

Sorry that you are having to go thru this frustration. But I would say again make your insurance company the final answer. If Blue Cross tells you that they do not accept lower BMI patients then that would be the end of the line. The coverage I have with BC/BS TX will accept lower BMI candidates but you do have to have co-morbidites. Not sure what your health history is like. But things like hypertension, diabetes, sleep apnea etc. They told me exactly what co-morbidities would qualify a lower BMI patient. Now if your SURGEON just has a specific BMI patient that they will only work with I would suggest changing surgeons if your insurance says you can have the surgery with a lower BMI. Hang in there. And their decision does not change that you a worthy!! You deserve to try and get the help you need. Good luck.