Anthem BC/BS cover lap band?

[choldren 0]

Just wondering if anyone having lap band surgery was paid by Anthem BC/BS insurance? Anthem (VA) told me Bariatric surgery was covered under my policy but only if I had a BMI of 40 or 35 if I have life threatening problems. My BMI is 34.5 and I have no (that I know of) life threatening problems. I think I'm going on to MX to have it done and self pay since it's cheaper and they do have more experience but just wanted to see if anyone else has had a similar situation as mine before making my final decision.

**** Also, if anyone has any input on their experiences in MX and lap band surgeries I would love to hear them. Thanks so much!

[maw 0]

Just wondering if anyone having lap band surgery was paid by Anthem BC/BS insurance? Anthem (VA) told me Bariatric surgery was covered under my policy but only if I had a BMI of 40 or 35 if I have life threatening problems. My BMI is 34.5 and I have no (that I know of) life threatening problems. I think I'm going on to MX to have it done and self pay since it's cheaper and they do have more experience but just wanted to see if anyone else has had a similar situation as mine before making my final decision.

**** Also, if anyone has any input on their experiences in MX and lap band surgeries I would love to hear them. Thanks so much!

I also have Anthem and live in VA. I would suggest seeing if ypur doctor's office has any better luck with getting coverage. You are close on your BMI. Do you have things like sleep apena, high cholestrol, heart issues, etc. These are some of the things the insurance company is looking for. The doctor's office has lots of experience working with insurance companies.

Some thoughts to consider. During the past general assembly session, I received a call my by Doctor's office saying that there was legislation being brought forth to take coverage of gastric bypass surgery out of insurance coverage. What my doctor's office told me was that for lap band fills, I would end of paying about $600.00 per fill ($100.00 for the doctor's office and $500.00 for use of the hospital radiology department equipment. This scared the heebee geebeeies out of me. I was banded in 10/08 and have had 3 fills since then. I knew if this insurance legislation passed, I'd be up one long, bad creek with no paddle! PS I don't think the legislation passed based on information in the newspaper but open enrollment for our insurance is just around the corner and I'll know for sure then.

I would suggest that before you make a decision about going to Mexico, that you read through some of the threads on this website from folks who have gone to Mexico and some of the difficulties finding a doctor where they live to do fills. You may want to check with the doctors in your area to see if they will do fills if you go elsewhere for the surgery.

Good luck with your insurance and your decision.