BCBS Choice PPO of IL

[Belle4243 0]

Hi guys. I’m debating about going to Mexico for a gastric sleeve instead of jumping through all the hoops insurance is making me go through. all though I am covered, anyone else who has this insurance blue Cross blue shield ppo choice of Illinois, can you tell me how much you paid after insurances portion? I’m worried I’ll pay more here so I’d prefer Mexico. Also it would be so much more quicker and I’m running out of patience.

Edited July 12, 2021 by Belle4243

[bufbills 316]

I paid out around 1300. My deductible was 1500 if I remember right with a max out of pocket of 1900. BCBS of Illinois. Hoops were not bad at all for me. Surgery within 10 weeks of my first visit.

[Sosewsue61 3,185]

Yes, I really only paid the deposit for surgery of 1,000, doctor co-pay, and the psych exam and nutritionist which was around $400. It depends on the exact policy, and what your out of pocket max is, etc.

But the whole bill was around 50,000 which is ridiculous.

Hoops were 6 months of NUT appointments, psych exam, and no gaining.

Edited July 12, 2021 by Sosewsue61

[Belle4243 0]

I have I think $2500 deductible and $4500 out of pocket I believe. Im just scared to havinf a large bill. I paid about $6000 for giving birth just last year all these bills from no where everyone just wants a piece of the pie so I’m worried. I think I’ll end up paying a lot, I don’t know how you guys got off so easy, great for you guys! I have to do a psych evaluation nutrition dietician evaluation sleep test and some esphogaus thing where I have to actually be put to sleep so worried for that bill too.

[Belle4243 0]

I want to say they do 80 I do 20 something like that

[Sosewsue61 3,185]

The EGD is nothing to worry about, it was part of the whole program.

The state of Illinois requiresbariatric surgery to be covered by insurance.

[Belle4243 0]

Ok thanks I think I’ll stay in the states. I was going with Oasis of Hope but just saw a recent article last month where someone’s intestines were stapled and she had emergency surgery it was bad. My next choice is ALO bariatrics but now I’m terrified to go to Mexico idk. I guess it’s a risk we all take

[catwoman7 11,285]

36 minutes ago, Belle4243 said:

Ok thanks I think I’ll stay in the states. I was going with Oasis of Hope but just saw a recent article last month where someone’s intestines were stapled and she had emergency surgery it was bad. My next choice is ALO bariatrics but now I’m terrified to go to Mexico idk. I guess it’s a risk we all take

there are some excellent surgeons and not-so-good surgeons there - you have to do your research if you're going to go abroad. But yea - that case was horrific!

[Belle4243 0]

Definitely I been researching for weeks now and it seems like something always comes up. I have a consultation next week with the dietician so I’ll see how that goes and make my decision to keep it here or go to Mexico.

[Maisey 260]

Call your insurance company and go over it with them. Take notes and be sure you understand it. Policies administered by the same companies differ depending upon the contract they have with specific employers.

[SleeveToBypass2023 2,682]

On 7/12/2021 at 12:59 PM, Belle4243 said:

Hi guys. I’m debating about going to Mexico for a gastric sleeve instead of jumping through all the hoops insurance is making me go through. all though I am covered, anyone else who has this insurance blue Cross blue shield ppo choice of Illinois, can you tell me how much you paid after insurances portion? I’m worried I’ll pay more here so I’d prefer Mexico. Also it would be so much more quicker and I’m running out of patience.

So I have BCBS of Illinois (PPO) and I had my normal $25 copay for the psych eval, my $40 copay for the surgeon visit, the dietician visit was covered, and my only out of pocket was the $500 deductible and $1000 out of pocket cost. I also didn't have many hoops to jump through. I had already tried a number of diets so my PCP was more than happy to do the clearance letter. I had to have the clearance letter from my PCP, bariatric bloodwork, an ECG, 1 dietician appt, the psych eval and either have a bmi of 35 with at least 2 co-morbidities or 40 and up with none (I am 40 and up with 2, so I definitely qualified). From the time I started the process on Feb 28th to the time I completed everything and it was submitted to BCBS it was 1 month. They approved it in 48 hours and my surgery is scheduled for May 3rd.

[Crisscat 182]

The amount of requirements and perquisite's for insurance to cover can be C R A Z Y no matter what state or insurance company you have. I live and work in IL and I have Healthlink PPO. My insurance had no real perquisites per se other than I had to go to 2 seminars for the program. Now I cannot speak for everyone's journey but my own and this is what I came across. Although my insurance had no real requirements to be met, the Dr I chose sure did!! I started my first workshop on Oct 28, 21. Since I already knew my health insurance had little to know requirements I had it set in my head that the week after Christmas Id be scheduled for surgery WRONG lol. I met a nurse practitioner at my Drs office that was like hitting a brick wall LOL. She is awesome dont get me wrong but she set me straight real quick. Depending on the Dr there are loads of tests and other Drs you have to be cleared by first. I mistakenly thought it was my insurance that required alot of this and I couldnt understand why by Feb I still had not been cleared for surgery. This nurse politely informed me that my insurance is not the one that determines the surgery clearance but the DR, they are however the source of payment so a major point to but in my program I had to show I had no weight gain in 6 months/ April was my 6th month since the start. Once I weighed in and still had no weight gain they then sent for insurance approval and like Future Sleeve Diva above, I had approval very quickly and surgery was scheduled within days of that. It can be a long process for some but it will happen in due time. It can be frustrating to have to wait but it will come and when it does then you may start asking yourself if your ready for it lol.

PS....I have not had any out of pocket yet except the initial consultation with the Dr ($35) I believe I had 1 other office visit charge of $35 but so far thats all

Edited April 18, 2022 by Crisscat
forgot to post more info