Insurance help!

[charley27 164]

I’m looking to have a sleeve to bypass revision but I’m not sure what my insurance will cover. Is anyone on BCBSIL PPO 204 plan?

[AZhiker 2,251]

I have BCBS as well. You can find all the information you need on their website. Just do some searching and you will find it all spelled out.

[catwoman7 10,852]

even if BCBS covers it, your employer may or may not have included it in their policies. They can pick & choose what they want included in their employees' policies. I'd call the customer service line on the back of your insurance card and ask.

[Jaelzion 1,123]

I'd do what both AZhiker and catwoman7 said. I would ask customer service but if they tell you it's not covered, I'd do some more digging because I've gotten erroneous info from customer service many times. You should be able to find your specific benefit info on the BCBS website if you've created a personal account and you can read for yourself what it says about weight loss surgery. I might do that first, so that when you talk to customer service, you'll know what your written benefit info says. Good luck, hope it works out for you!

[redhead_che 824]

On 11/4/2020 at 8:06 AM, catwoman7 said:

even if BCBS covers it, your employer may or may not have included it in their policies. They can pick & choose what they want included in their employees' policies. I'd call the customer service line on the back of your insurance card and ask.

This is how I found out my plan didn’t cover contraceptives, but does cover WLS 😳😬 definitely call your plan and ask specifically.

[Lillimint 48]

My version of BCBS does cover WLS, but I called them anyway to confirm. It was a fairly lengthy phone call as they went over all the preop requirements. Then they sent me their coverage info so I could look it up or refer to it on my own. The approval process required 3+ months of various appointments (cardiologist, psychologist, 3 months of nutritional counseling, PCP visit, etc.) so there was plenty of time for the WLS office to work out any kinks (there weren’t any). After I had gone to all the various appointments the WLS office called BCBS to verify final approval and set the surgery date. That took maybe 10 days. I got the impression it probably goes slightly quicker in non-COVID times. With the whole process there really isn’t a possibility that I could have ended up getting expensive surgery without insurance approval, something I was concerned about in the beginning.

[AZhiker 2,251]

The more initiative you take in this whole process, the better off you will be. Don't assume anything. Get and keep copies of EVERYTHING - like cardiac clearance, psych clearance, pcp notes, everything. Find out for yourself what your insurance covers and know it inside out. Write down the names of people you talk to, along with dates. Basically, start keeping a log of all conversations, visits, tests, and results. It will be invaluable to have when some one gives you the run around or the doc office loses the results of something.