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KEYSTONE HEALTHPLAN EAST (BLUE CROSS HMO)

KELLY R.
on 9/13/10 3:18 pm - PA
RNY on 04/04/12
Hello friends... I have a question.  My hubby and I finally got new health insurance and it's Keystone Healthplan East (Blue Cross HMO).  Now I know they will do bariatric surgery but I'm not sure about their procedures.  I'm sure I'll be considered more than "medically necessary", but I'm tyring to get a feel for how up hill this is going to be.  I'm very determined... I've been waiting nearly 4 years to try and do this so I don't plan on stopping now. 
My main questions are ...
Did you need a referral from your PCP to have a consult with a surgeon?
How long did it take you to get approved?
Did KHE/BC require you to do a 6 month monitored diet first?
Did they cover 100% of your surgery?  If NOT, then how much did they cover?

Thanks in advance for the feedback folks... it's highly appreciated!

xoxoxo,
Kelly

Peace & Blessings... Kelly                                             

    

HW 292 / CW 191 / GW 130

    
amy C.
on 9/13/10 6:41 pm
 My surgery was 2 years ago.I had this insurance when I had my surgery, now somehow I believe amerihealth was involved but im not sure, my card said khpe.  Anyway My first consult was april 7th my surgery was approved in about 2 weeks and I was scheduled and had surgery on june 2.  I had to pay my co -pay for a hospital admission which was $250 per night so that was $500  total. I dont remember paying any other co-pays.  So no diet , no psych eval, no cardiology appt just an ekg woith prehospital admission stuff, I had a pulmonary test but im an asthmatic, i also have factor five lieden so i had to see a hemotologist.   I thought the insurnace was awesome  and things went great with them.  I know you usuaully see only  postings about bad dealings with ins companies but I had a great experience, I hope this helps.
amy C.
on 9/13/10 6:43 pm
Oh by the way I had my surgery in PA even though I live in De.