I got approved about a month ago but I figured I would let people know in case anyone else wonders about things with this insurance.

I have Anthem Blue Cross Blue Shield PPO. It took about a month before I was approved. They claimed they were very behind for some reason so it took longer than normal. I only had to show some kind of proof that I attempted other weight loss methods and failed. In my case this included a life long history of up and down diets and I tried phentermine for a couple of months.

They are also going to cover the assisting surgeon and the Lovenox injections after. They approved me for same-day outpatient (unless of course there's a complication).

Hope this helps someone at some point! Surgery date is October 15, 2007!

wow $2800? not really

but like you said lana24 if you gain more weight it will cost you that much in wardrobe let alone the money we all fork up trying to loose the weight again..

i agree money well spent..!!!

plus medical expense deduction on your taxes

The support groups can definitely be useful! It's really good to hear from others going through similar things and understand how things are for you. A lot of people just don't understand it all. Support is good.

Dustout,

My Dr. is basically a bariatric surgeon, he can perform other types of surgery related to the digestive system, but he is known as "The Band Doctor." However he doesn't have a private surgery center. He uses two hospitals in the Cincinnati Area. He and his staff are awesome. I don't care if I email them at 10:00 p.m. someone will respond! (Even though I say "wait until office hours, this isn't urgent.")

You had asked about the diet in a previous post. I am currently on the pre- op low-carb high Protein liquid diet for two weeks. This is day 3. The day prior to surgery, I'll be on Clear liquids, until midnight. Following surgery, it's ice chips until liquid is toleraged. By the next day I can have pureed foods for two weeks then soft (mushy) for two weeks. I was totally surprised the liquid is before not after.

I'm learning that every doctor has their own ideas. My DH was on full liquids two weeks prior, clear liquid one week post, full liquids two more weeks, then pureed followed by mushy. That was two years ago. I think the facility (Barix) was still following the open RNY diet as they had just started doing lap-band.

My sister had lap band & gall bladder a few weeks ago. She only had to do full liquid 2 days, clear liquid one.

I guess the important thing is to trust our doctors and follow instructions.

Lana,

If that's the only money you will spend out of pocket, it's not nearly as much as we paid in co-pay two years ago to the out-of-network facility for my DH. Two years ago there weren't so many options and we were less informed than now. But it was money well spent for the health, peace of mind, and new life my DH has.

Absolutely stick with where you know you are going to get the best!!! I think that half the battle is trusting our doctor. We all have been through the doctors who offer us no real solutions but rag on our weight.

Surgery $$$$

Pre op visits $$$$

Peace of mind and healthy life.... priceless!

Lana,

If that's the only money you will spend out of pocket, it's not nearly as much as we paid in co-pay two years ago to the out-of-network facility for my DH. Two years ago there weren't so many options and we were less informed than now. But it was money well spent for the health, peace of mind, and new life my DH has.

Absolutely stick with where you know you are going to get the best!!! I think that half the battle is trusting our doctor. We all have been through the doctors who offer us no real solutions but rag on our weight.

Surgery $$$$

Pre op visits $$$$

Peace of mind and healthy life.... priceless!

Ellisa,

You are so right, after yesterdays post I was slightly in doubt but I am ok now...my heart knows where it needs to be.

thank you

did you appeal????

Tweedy,

Who are you asking?

ok guys....

I have completed all preop requirements........yessssss:clap2::clap2::clap2::clap2::clap2:

Ok...the doc office called me...they are waiting on cardiologist report which she should have gotten by yesterday and the letter from my pcp i am medically stable.

So, with that said she will be calling me when she submits which should be at the latest next friday....

ah....getting the shakes just thinking about it...:cry

wish me luck!!

I'm in Oklahoma but we always mail payments and stuff to Anthem in Conneticut. I also have PPO.

Either way, Anthem itself has a main policy on Lapband which they created early this summer. Here is the link on what is required to be banded under anthem:

Redirect Page

This is NOT state-specific. It's extremely informative.

It took me about a month for insurance to reply. However, my surgeon only had expected about a week or two. I called insurance and they told me "We're about a month behind". Anyways, I hope you find out soon and good luck with surgery! I'm excited! Only a few more days to go...

Thanks so much, it's such a comfort that you are all out there.

:scared:

SURG.00024 Surgery for Clinically Severe Obesity

congratulations!!! i hope to soon be taking these steps myself! since my weight has always been a problem, how does the psych exam deal with the issue of "eating disorders"? are we considered eating disorder patients because of the yo-yo dieting? i'm really happy for you,

Lynnemarie :scared:

Yes and no..

My psch doc was great... he just asked basic questions to make sure I didn't have an eating disorder such as bulemia, anorexia, etc...

but on the psych eval which he sent me a copy of it does list as me having an eating disorder but just in general not an specific one only because we go from diet to diet....and we are successful, but then we suppress that and go to the other extreme where we allow ourselves to overeat, gain and not be able to control it.

My psych eval was basically to ensure that I was competent enough to understand what the surgery entailed and had the ability mentally and emotionally to follow the aftercare plan. Kinda like is a suspect competent to stand trial. LOL

:funnypost::crazy:yep....not loco in the cabeza

Can anyone give me advice on how to write an appeal letter to BCBS?

ah...Sue I am so sorry....

no I don't know how to...but I will see what research I can do to help....

Please share with us if you come accross anything....