Frustrated!!! I'm almost done with my 6th month supervision weight in. I called blue shield to get some up to date requirements over the surgery to my surprise l was inform that after they review my case then l get put on a "waiting list" l was never informed over this.... I have been through this journey almost a year.... Don't want to give up ,but I'm very frustrated!!! Has anyone been through medical approval (California) Any advice is Welcomed

This topic says "Blue Shield of California", so I am responding with the assumption that you and other posters have Blue Shield of California. If you have another insurance provider, this is not a good thread to ask your question.

OMG I'm sorry..will this surgery help my brain too? Hehe

Thank you very much for all the help and information. Insurance can be so confusing!

Edited November 20, 201510 yr by la.pereira

I am currently employed and my employer excludes bariatric surgery on their insurance policies. I have been through appeals for the last year and am finally just ready to go out and purchase a healthcare plan outside of my employer and pay the extreme out of pocket cost for the premium to have this medically necessary surgery... My question is there ia the bronze, silver and gold etc Blue shield plans but all say they "cover" bariatric- How much did you guys actually pay out of pocket for the surgery, hospital stay etc? I am just trying to plan ahead- if I have to pay the premium and a deductible I want to be prepared.

I am currently employed and my employer excludes bariatric surgery on their insurance policies. I have been through appeals for the last year and am finally just ready to go out and purchase a healthcare plan outside of my employer and pay the extreme out of pocket cost for the premium to have this medically necessary surgery... My question is there ia the bronze, silver and gold etc Blue shield plans but all say they "cover" bariatric- How much did you guys actually pay out of pocket for the surgery, hospital stay etc? I am just trying to plan ahead- if I have to pay the premium and a deductible I want to be prepared.

My total out of pocket cost for the surgery, hospital, follow up, etc -- was somewhere less than $1200. The actual bills were more than $100,000.

I am currently employed and my employer excludes bariatric surgery on their insurance policies. I have been through appeals for the last year and am finally just ready to go out and purchase a healthcare plan outside of my employer and pay the extreme out of pocket cost for the premium to have this medically necessary surgery... My question is there ia the bronze, silver and gold etc Blue shield plans but all say they "cover" bariatric- How much did you guys actually pay out of pocket for the surgery, hospital stay etc? I am just trying to plan ahead- if I have to pay the premium and a deductible I want to be prepared.

My total out of pocket cost for the surgery, hospital, follow up, etc -- was somewhere less than $1200. The actual bills were more than $100,000.

But that coverage was for my plan, etc. Your coverage on an exchange plan is going to differ. It's pretty complicated to estimate, unfortunately. You need to look at per year maximums, life time maximums, out of pocket expense maximums, etc. We basically have the best version of the BSCA policy my partner's employer offers, and that's a really great policy. We also were careful to use in-network for everything.