Anyone have dealings with Independence Blue Cross?

jenmboyd
on 1/7/16 4:50 pm

Hello there!  I'm new to the forum, and wondering if anyone else has the same insurance with me, and therefore, the same issues I might be facing.

I'm hoping to undergo weight loss surgery, specifically the sleeve, sometime this year.  I've been following all the steps laid out by Portsmouth hospital.  In the fall, we hit a small snag with my insurance, and within a day of that appointment, I got a letter in the mail stating changes to the insurance benefits.

So I went on ahead with what I was doing.  Fast forward to now (Jan.), and I was told that another patient with the same insurance as me has been denied.  I looked back over the papers I received.  Based on the the letter I got, all plans were affected (HMO, POS, DPOS, and PPO).  The exclusions on obesity have changed.  The exclusion does not apply to surgical procedures specifically intended to result in weight loss (including bariatric surgery) when the health benefit plan or claims administrator (as applicable)-

   -determines surgery is medically necessary; and

   -surgery is limited to one surgical procedure per lifetime regardless (or even) if: and then it lists the reasons.

The way this is worded, it can be interpreted almost two different ways.  Anyone else deal with Independence Blue Cross recently? And if so, what were your outcomes? 

Thanks for reading :)

(deactivated member)
on 4/3/16 2:42 pm

Yes independently Pennsylvania nothing but rejection multiple times not even for removal of a lap band

Most Active
×