Do they always go in laparoscopic?

[hmills653 365]

Ok so I spoke to my insurance people and I think I'm more confused and frustrated. Lol.

1. They will cover me if medically necessary. - ok great.
2. She tossed out a bunch of numbers to me when I asked her how much I would owe on my end. I explained that this was all new to me as far as dealing with insurance and she really didn't elaborate more on what I was asking her to in reguards to my payment part if there was anything. She aid "well you haven't meant your $250 deductible yet and you won't pay more than $6k in co payments for the year" - umm ok...more confused.
3. I asked her about the info linked to the screenshot I posted and she simply replied "yes that isn't anything knew and it's like that sometimes" - I felt this was so vague.
4. She kept telling me ALL wls are outpatient. I said not from all my research they're not..I explained all the info I've got on here and from watching YouTube videos from others and they all stayed at least overnight. She kinda argued about that saying it's all outpatient and it's been like that.

So I'm frustrated thinking I would have better info today but I don't. Ugh. Thank you to all who commented...I have gotten more info and help on here than anywhere else.

So it sound like you have a $250 deductible which means you have to pay the first $250 off medical bills when the year starts. Then the yearly maximum is $6000 so that means after you have paid $6000 towards your medical bills then the insurance will cover the rest of the year at 100%. So for example I have a $1300 deductible then after I've paid $1300 them my insurance will pay 90%and I pay 10% until I've paid $5000 that is my out of pocket maximum.

[CrissCriss 97]

Seems like your gonna have a fight on your hands.

[Sosewsue61 3,185]

Log onto your online portal and your benefits will be in writing, there will also be a way to email them with direct questions. When you call up your ins company these are 1st line customer service people that just regurgitate the policy - they do not make decisions regarding your approval. There are intake specialists that decide that on a case by case basis.

Back to that email you will compose - ask very specific questions, such as if my surgeon advises the sleeve gasectromy laprorscopic surgery is that covered based on my current medical diagnosis (bmi, any co-morbidities etc), etc. Ask when it wouldn't be covered? Etc.

And the surgeon's office has an insurance specialist that may have submitted to your particular insurance before and knows exactly how to code the surgery and submit so it will be approved - that is if the surgeon's office is a good one.

[Sherry Rice 184]

Ok...I took a screenshot of what someone sent to me saying some won't pay for it laparoscopic. Hopefully I can upload it here somehow..still new to this site [emoji4]

That is a battle you will NOT WIN against BCBS. I know because I tried! I am now self pay.


51 year old woman
VSG DATE: 10/28/17
5' 5"
HW: 259
CW: 249
SW: ---
GOAL: 135

[VSGnewguy 164]

I also have BCBS (of Illinois) and have been approved for VSG. Definitely work with the insurance specialists at your surgeons office. They should be experts at navigating what is and is not covered.

[BDME 138]

I thought vsg was always laparoscopic. Why would the insurance company want them to cut you open? Therefore extending your downtime? That sound counterproductive