Question:
BCBS Blue Card Plan?
I contacted them and was told that all they require is a letter of medical necessity from the doctor is that true? If you read my profile you'll understand my reluctants with insurance compaines. This is new insurance for my family it came into effect Jan. 1. Thanks — jennie_jen (posted on January 9, 2004)
January 8, 2004
I went to a surgeon, referred to me by my pcp, but there are many tests
that you are going to have to go through before you have the
wls,(Cardiologists, Mental evaluation, Sleep study, Etc.) But you will
most lkely be all set, I too have bc/bs, but the process is long. I
started the whole procedure in April 03 and finally got a date for Feb 04.
But it is worth all the work. I wish you the best of luck.
— penelope R.
January 8, 2004
It is most likely that you will need a letter of medical necessity from at
least one of your Dr's. That is very standard. It's a simple letter. If
your PCP referred you to a surgeon, it's because he feels that you seeking
this surgery is medically necessary. Getting this letter is simple if you
have any co-morbs at all. Your PCP and/or your surgeon can write one. So,
if the insurance says your require it, why question it?
— LMCLILLY
January 8, 2004
I have BC/BS PPO and yes, they did need a letter from my primary doctor, as
well as a letter stating that I was medically cleared to have the surgery.
I didn't feel comfortable with my previous doctor, so I actually switched
to a new one and he was all for it. It wasn't a problem at all. Best of
luck!
— Ann B.
January 9, 2004
Wonderful ins. I went to the surgen didn't even tell my PCP until after.
(Another story) Dr. Johnells office took care of everything and I am very
happy with them. WLS was the best thing that i have ever done for myself.
Best of Luck
stacy
— stacy A.
January 9, 2004
I had BC/BS when I had my surgey & they were alot easier to deal with
than I expected. I know they required a letter from my PCP,but that is all.
I really am not sure what he wrote in the letter,but it worked. I was
prepared to have to fight for an approval due to hearing so many other
peoples insurance nightmares,but it went suprizingly well.
Best of luck to you!
— melmas
January 9, 2004
I have BC/BS of IL.PPO and in April of 2003 I called them up and they said
the same thing. It must be medically necessary and you needed a letter
from your doctor. You must have a BMI of 40 and up and co-morbids. They
made it sound so simple. Well now I am on my 3rd appeal. And I'm starting
to believe they will never approve me. They claim I need 6 months to a year
of documented doctor supervised diets. After my first denial I asked them
for documentation of what they required before they approve and they can't
seem to produce anything for me. Call them up and ask if they can give you
some documentation of what they told you on the phone. And make sure you
keep a log of every phone conversation,dates, times, and names. Good Luck
— Kara J.
January 9, 2004
I have BCBS, I had to jump through alot of hoops for them to approve my
surgery. I had to have a 6 months doctor supervised weight loss plan. I
had to have a psych evaluation, I had to have a nutrition
evaluation...after they had turned me down saying it was pre existing
because I had been to a doctor for a weight loss program....Good Luck they
are tough cookies and according to my doctors office are about to get
tougher...they are wanting to quit paying for wls at all...I hope you have
it easier than I did.
Good luck,
JAN PARK
— Fancy
January 9, 2004
Most insurance companies require a letter of medical necessity.. and that
should be standard from your doctor if he does a lot of WLS. I think it
could also come from your PCP if you have one. I have BCBS and as far as I
know, that's all I needed, no hoops -- the doc's office really did it all.
Good luck.
— Lisa C.
January 9, 2004
I have BCBS of Illinois. They sent me this letter in early November, 2003
stating that I only needed 6 months supervised diet under my PCP.
I happened to call them on 1/8/2004 to ask a question and now they are
telling me it's a whole year of dieting under my PCP.
Some people have told me that don't sound right and I should question more.
Would be interesting to hear from others on this one
[email protected]
— CuteDonna
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