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Those with BCBS of MA how much did they cover?



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For me, they covered everything except the $250 copay for the hospital. I am very happy with BCBS MA.

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I haven't had my surgery yet, just starting the process with all of the appointments, but they told me all I had to pay was the $250 co-pay for the hospital.

Best of luck!

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I had to pay $500 overnight at hospital fee. In addition, I had to pay $175 for psych appointment. Now that I'm banded I have monthly consults with surgeon. If I get a fill there is no copay. If I don't get a fill then I pay $20 copay for the visits.

Sue

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I also just had a $250.00 copay for the hospital and all of the copays for the first 3 months going to dr visits were also covered.

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I have BCBC PPO "Blue Care Select" I think its called. I called them first to find out the policy and if they covered it before I even choose a surgeon. They mailed me the section about WLS with a few days. It was good to know ahead of time that it was covered.

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I have blue care select also, thank you everyone! We just got chosen to adopt another baby, and all of a sudden I am freaking out about finances.

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Congratulations KathrynRose on your upcoming adoption. How exciting.

Sue

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Thanks for the congrats! Right now I am having a hard time keeping everything straight between the surgery, the adoption, and my mother being in the hospital.

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I have BCBS Ma and they pay everythinge regarding the band surgery except my co pays for office visits. They pay all the fills as well and paid for my panniculectomy too!

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Marypetunia:

I checked out your blog and couldn't find the answer. How did you get BCBS to cover your panniculectomy? Did you have to pay extra for your ps to tighten your ab muscles?

You've done so well with the band. Congratulations.

Sue

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Hi Sue,

Yes, BCBS paid for the panni removal only, I paid a bit extra for the muscle tightening because that is considered cosmetic. I had to get a "letter of medical necessity" from my primary care doctor, which basically stated that I had consistent rashes and back pain from the weight. My PS took pictures, which to be honest, I think REALLY told the story since my panni was VERY large. My PS actually removed almost 14 pounds of excess which was quite a bit. SHe did an "anchor" cut so she was able to get alot of the excess upper abdominal skin as well. It has healed up beautiflly and I feel so FREE with it gone! I never thought I'd get to that part of the journey, so I am thrilled. If you have other questions, feel free! this site has been a big reason I've been successful, I have gleaned lots of good tips and information from those who have used the band to their best advantage!

It's a GREAT tool when used right!! You're doing great too!!!

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I have BCBS/MA also and it seems it depends on your secific plan. For my plan the procedure was covered 100%. I had to pay several co-pays ($15 each) for the consult and psyciatry visits. The biggest expense was $500 that the hospital (B&W) charges to cover the cost of materials, lifetime nutrition appts, and support groups. My employer also offers a Flexible Spending Account (FSA) and I planned on the expenses in advance. If your employer offers it, it is definitely worth it. When benefits are selected you choose the yearly amount which is then deposited to a Visa card. The money is available up front but you pay the amount weekly out of each pay check. Since the money is paid w/ pre-tax dollars, there are a lot of savings (sometimes as much as 40%). The hospital fee and co-pays can all be used with the FSA card.

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i just got off the phone with bcbs (i'm in ny...but they are about the same). inpatient is $250 copay...outpatient is $75 plus $25 for the dr. everything else was covered. i was under the impression with the woman i spoke with that bcbs wants you to know all your copays up front. give your ins. a call. good luck & God bless

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