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BCBS MA question...

LTjr

By LTjr, in Insurance & Financing

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LTjr    0

LTjr
Posted

Have any of you who are in Mass with BCBS had problems getting approved?

I am being submitted for review with the surgeons tomorrow,then, if approved by them,submission to BCBS?

Would they not approve it if I hadn't been to a supervised WL program?

My BMI is 49 and I have 2 co morbidities....

I have a gym membership(a lot of good that's doing), trying my own diets for years, but never a jenny graig or weight watchers. I've taken pills, slim fast...all that crap.

Has anyone here ever been denied because of this? I guess I am freaking out a little.

Thanks.

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NURSEDSD    0

NURSEDSD
Posted

I have BcBs Ma and I just found out last night that my plan does not require any medical authorization or pre cert. I just have to meet the medical criteria and I am good to go. So I called my surgeons office this morning and they are scheduling me for Friday probably... I am so excited I thought it would take a couple of months.. I was at the doc's office on Monday and maybe surgery on Fri. Hope that helps:clap2:

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AngelSoftSnow    0

AngelSoftSnow
Posted

I have HMO Blue New England...has anyone used this type of insurance for coverage. I'm just starting the process and want to know what I'm up against. I have schedule a visit with the surgeon for september 2007. I'm hope to get an appointment sooner. ;)

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NURSEDSD    0

NURSEDSD
Posted

Hi I have BC/BS of MA PPO. It was so easy from my first visit till my surgery was 10 days. They required no pre cert or pre authorization. You can go online and look at the medical policy for bariatric surgery at BCBS.com. Good luck. I hope it is as easy for you as it was for me. Banded 6/26/07 I have lost 15lbs in 16 days...Donna

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LTjr    0

LTjr
Posted

I just got my approval in the mail today, no sweat. Date is set for August 1st.

There were no hangups, probably because my case is bad. Pre op diet starts Monday....ugh.

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babs0101    1

babs0101
Posted

Congrats! I have Health New England and they require I do a year of supervised diet! Good Luck!

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kmg1997    0

kmg1997
Posted

hi there!

i am in Mass too . I just went to my seminar to day at Lahey Clinic. I have BCBS as well and I am afraid that they will deny me. I have a gym membership as well, I have 3 years of weight watchers books to prove i went there and i think i can get a note from my primary care doctor. i think it depends on the plan you have as to if they cover it. have they been giving you a hard time already or are still waiting for your intital approval? i wish you the very best of luck ! i will keep my fingers crossed for you getting approved :wacko:

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AngelSoftSnow    0

AngelSoftSnow
Posted

I was told by the surgeon's office that HMO Blue New England will be fine and that they would get it approved for me. My primary has sent the surgeon a letter stating that she supports me and recommends the surgery. My bmi is 43 and I have a thyroid problem. I can't wait to see what the surgeon would say when I meet with him on 9/27/07. I hope I don't run into any problems.

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Go To Topic Listing Insurance & Financing

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    • Alisa_S

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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      1. summerseeker

        summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

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        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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