Ok,

Which is better on coverage? Basic or Standard? I have basic right now. When I had my band in Jan 2010, basic was the way to go. I only paid 100 co-pay surgeon and 100 co-pay to the hospital...very easy process and approval. I wasn't even required to do the psych eval or 6 month diet plan.. I was approved and had the surgery in two weeks after approval. I saw the doctor initially a month before surgery.

Right now, I may be able to get my band removed and possibly get a revision surgery done to the sleeve... due to slippage and doctor not being able to access the port.

Are the lap band to sleeve insurance requirements the same and pretty easy? I just don't want to have to go through all the hoopla with the diet for 3 or 6 months and the psyhc eval. I want it done ASAP if i'm having complications.

From my experience in the past before my lap band, a lot of weight loss "clinics" I called inquiring about the insurance and the surgery..and they all still required the pre stuff, even though a studied my insurance and knew that I didn't. I tried to tell them, that I had federal insurance and not regular blue cross blue shield insurance and it wasn't required for me to do all the pre surgery stuff to get approved. I finally found a doctor in Dallas that the insurance lady was very hip and knew that I didn't have to go through the requirements and had my surgery fast.

I'm hoping it is the same time around this time.....any input would be greatly appreciated and thanks in advance!

True!! Goodluck to you as well!!!!

My revision surgery is scheduled November 5th! My band slipped and the port is all messed up! He gave me the option of having the surgery in 3 weeks but I just need more time to think it all over and get things set. I'm not required to do 3 month diet, etc.

He told me to decide on RNY or Sleeve and today I told him i'm leaning more towards the sleeve, so that is what he signed me up for. But, i'm actually thinking about RNY now and I might get that. I need to read a lot more on it.

150 co-pay hospital and 150 co-pay surgeon.... and 30% of drugs so i'm happy about that. I'm still going to call the hospital once everything starts getting into the process and try and get out of the 30% for drugs costs. lol

Just as I thought! Good deal!!! If you find out about how much the 30% will be, let me know please!!! I'm trying to figure it out as well!!

Ok I will. I'm hoping all of it is in-network.

I just called my doctor insurance coordinator and she said they have to schedule me with an in-network hospital so all charges should be in network and she doesn't see me having to pay 30% drugs. I'm still going to double check when the hospital calls me to set up surgery and get it in writing.

So if the hospital is in network then you don't pay the 30%?

So if the hospital is in network then you don't pay the 30%?

That's the way she made it sound.

That would be great!!!!!!!!

If you have basic IT HAS TO BE IN NETWORK, or they pay $0!!!!

Some of bcbs plans require center of excellence as well as being in network.

wonder why some hospitals charge 30% and some don't?

I have basic and I only paid 150.00 for the actual surgery and hospital stay. When I got the statment from BCBS they had been billed a total of 59,000$ from the hospital. The charges included surgery ,all drugs administered during surgery,my 1 night stay and all drugs administered after surgery. Insurance paid 29,000 and my cost was the 150.00 co pay for surgery. My surgeon's office was a center of excellence with BCBS , so I dont know if that made a difference in how it was billed or not.

Oh wow Silky!! I called the hospital where I'm having the procedure done . I was told $150 for te surgeons fee and 100 per night for hospital stay, then 30% drug/ supply cost.