BCBS PPO Florida

Ladydigs · August 16, 2003

Anybody have any experience with BCBS PPO in Florida? If so, how does one even begin?

victoriamal · August 17, 2003

i have bcbs of mich. i was approved in one week .you need to read your policy and see if there is an weight loss surgery excl. if not email me and i will help.

Ladydigs · August 18, 2003

Thank you Victoria. I will check my policy tomorrow when I get to work. Keep your fingers crossed for me!

Diane

Ladydigs · August 25, 2003

Well, I read my policy and called the company. WLS is NOT excluded! Woo hoo!!! First hurdle crossed. Now I want to do everything as right as possible from the beginning. What is the first step?

Alexandra · August 25, 2003

Ladydigs, the first step is to see if you can decipher what the criteria is your carrier uses to consider people qualified for weight-loss surgery. If it's not clear in your policy documents you might ask your surgeon for that info, or call the carrier directly. It will probably be similar to the list we've all seen: basically you need to have a BMI of at least 40 or a BMI of 35 with two comorbidities.

If you have a PCP, go see that person and have them make a diagnosis of morbid obesity. Then talk to your surgeon and see what the next step is. With a PPO it might be just having the surgeon examine you and then making a precertification request for surgery. If the precertification request is declined, you'll have more information about what to do next.

Good luck!!