Question:
Has anyone been approved with Blue Shield of CA(access +)HMO

I"ve been debating with myself to see if I can get approval because I have the HMO.I just have the fear of rejection.If I wait til October I can change to an insurance that will definitely approve,since I know a few people that have already done It. Any advice? I'M DESPERATE    — Jaime P. (posted on May 17, 2003)


May 17, 2003
Hi, I have Blue Shield of Ca. Delta IPA, HMO. I have already switched IPA's, from Allcare to Delta for this surgery. Your best bet would be to talk to the ins. person at the surgeon you have chosen. I did this and she was very helpful in telling me how the ins. worked. You could even call Blue Shield and get the # for Access+ and ask them if they cover bariatric surgery. Blue Shield does cover the surgery if it is medically necessary, however getting through your medical group (IPA) could be another story. If you have any other questions please feel free to contact me. Danni
   — mytime

May 17, 2003
I have BlueShield Access+ HMO. I got approved in less than 30 minutes. My advice to you is to go with it. I hated that we were changed to BlueShield, and really did not want this insurance, but they approved me so fast I was stunned. Make sure you have doctor's that are behind you, and make sure they fax everything BS asks for. If you have ANY questions whatsoever please feel free to email me. I underestimated this insurance and I was WRONG! I'm having surgery next Wed.
   — Laydie K.

May 18, 2003
You have a great insurance. Call the 1-800 number on your medical card and talk to the insurance group yourself (DO THIS TOMORROW). You need to ask if your insurance policy covers gastric bypass for morbid obesity if it's deemed medically necessary by your Dr.? This does not in any way lessen your chance of being approved if anything it will tell you if your policy even covers it. The Dr's. are the ones who will write it up as being "medically necessary " for insurance to approve and believe me they know what medical terms to use. I hope this helps.
   — Maggie M.




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