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Blue Cross Blue Shield Ins

Hi! I'm a newbie to the forum. Two more nutrition appointments to go, everything else has been done. We have BCBS of IL insurance through my husband's employer, but we live in NY. Can anyone tell me, will the approval process go through our local Excellus BCBS or IL? Does anyone have experience with either? Just wondering how long it takes on avg to get approved from the time everything is submitted. Thanks!

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  • Twinmomma422
    Twinmomma422

    We have Bcbs of IL also and we live in Oklahoma. I had no problems getting my surgery approved. I met all my criteria which wasn't much and they approved me in 2 days!! Good luck!!

  • beachdreamin
    beachdreamin

    I was told as long as I met all the criteria I was approved. I have bcbs of Michigan

  • elizabeth105
    elizabeth105

    Thank you so much for your responses! I didn't mean to be rude, I couldn't find this thread to get back to you! So, according to BCBSIL, it will go through them for approval. Just the billing will be

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I am not sure, but years ago I had BCBS of MN through my employment even though I lived in the state of WA. All my claims went through BCBS of MN. Have you recently moved? Perhaps your husband's employer is big like mine was and just purchases all their policies through BCBS of IL. You should have something that tells you - your id card?

  • 2 weeks later...
  • Author

Thank you so much for your responses! I didn't mean to be rude, I couldn't find this thread to get back to you! So, according to BCBSIL, it will go through them for approval. Just the billing will be handled by my local insurance. But you go by the benefit of the actual insurance you carry, so I only have to follow the requirements for BCBSIL's medical policy. Which I am so excited for, because the requirements aren't as strict as Excellus BCBS (in Western NY) ;)

that is great! hope everything goes smoothly. When my paperwork was submitted to BCBS they approved really quickly (less than a week). Hope that is the same for you. Good luck!

  • Author

Thank you so much! And great job on your weight loss! 60 lbs since Oct is amazing :)

you need to call them & get them to send it to you on paper. I had called them 4 or 5 times

& each time they told me all I needed was a recommendation from pcp. then I finished all

the other things for the surgeon & paper work was submitted the came backing wanting

diet (6 month) details & dates. I had ask them about the diet on each phone call & they

said none was required. I had bcbsm ins.

Edited by Bigfuzzy

  • Author

you need to call them & get them to send it to you on paper. I had called them 4 or 5 times

& each time they told me all I needed was a recommendation from pcp. then I finished all

the other things for the surgeon & paper work was submitted the came backing wanting

diet (6 month) details & dates. I had ask them about the diet on each phone call & they

said none was required. I had bcbsm ins.

How annoying! I am so sorry you had to deal with that. I'll call again in the morning. Online they told me my surgeon would NOT be covered because it wasn't a center of excellence. I called this week and they had me on hold to research for 45 minutes!! they came back and told me she would be a covered surgeon. So, I know the call is recorded, if they give me trouble in the future I will have proof that they told me they would cover it.

I have BCBS of TX and luckily had no trouble. I think they prefer you go throught a center of excellence... my surgery is on the 27th and I was given two discounts from BCBS; one for going through a center of excellence and one for using that hospital's wls program. Luckily my deductible is super low.

It was approved after 2 days, but they don't send it electronically/fax....they mail it. That took about a week.

I wish you the best with your journey!

  • Author

I have BCBS of TX and luckily had no trouble. I think they prefer you go throught a center of excellence... my surgery is on the 27th and I was given two discounts from BCBS; one for going through a center of excellence and one for using that hospital's wls program. Luckily my deductible is super low.

It was approved after 2 days, but they don't send it electronically/fax....they mail it. That took about a week.

I wish you the best with your journey!

That's awesome that you were approved so fast! Thank you for the well wishes :)

I was told as long as I met all the criteria I was approved.

I have bcbs of Michigan

I too have bcbs of Mi the only thing I'm concerned with is I haven't met my deductible yet. How do i spend that up so that the insurance will pay the bulk of the surgery?

I was told as long as I met all the criteria I was approved.

Edited by L.o.v.e

We have Bcbs of IL also and we live in Oklahoma. I had no problems getting my surgery approved. I met all my criteria which wasn't much and they approved me in 2 days!! Good luck!!

I have bcbs of Michigan too the only thing I'm concerned with is I haven't met my deductible yet. How do i spend that up so that the insurance will pay the bulk of the surgery? Why pay more when you can pay less you know

  • Author

I have bcbs of Michigan too the only thing I'm concerned with is I haven't met my deductible yet. How do i spend that up so that the insurance will pay the bulk of the surgery? Why pay more when you can pay less you know

I hear you! Are you on any medications you can refill? That can eat away at the deductible. Or any doctor's visits you need? We've always had BCBS PPO plans, but this year we purposely switched to a high deductible plan. Our employer pays into the HSA for us, then we only have to pay around $3,500 out of pocket before the family deductible is met. Our daughter is a Type 1 Diabetic, so far this month, her insulin, needles, test strips, etc. alone have taken care of half our family deductible for the year! Our deductible will be met by end of Feb, so surgery should be covered.

I would do that, think of any appointments you can make, therapy visit, medications you can refill. Good luck to you :)

Hi there yes I have that too and I have plenty of medications but they aren't counted against my deductible because they always reimburse me. My daughter has OT so hers in maxed out already so far I've only spent $23 lol I need my $300 to be spent so I'm not paying full price. I have yet to get a date. My info was submitted 01/06/16

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