Question:
BlueCross California Care HMO-Any problems with approval?

I've already looked through the Insurer category on this website, but many aren't dated or the postings go back to '99. Has anyone recently been denied by BC CaliforniaCare (or the med group/ipa)even with a bmi over 40 & co-morbidites. If so, did you appeal & win? Thank you for any responses.    — mary V. (posted on March 28, 2002)

March 27, 2002
Hi, I had Blue Cross California Care, I had wls 12/5/01. My BMI was 40 and I had co-morbidities. The insurance company leaved it up to your medical group to approve or deny it. And if you appeal it will go to the insurance for review. I was denied at first and I sent an appeal letter to the insurance company and copied my medical group. Once the appeal letter was received letter was received my medical group over turned the denial. Every time I spoke with the insurance company they were great and helpful, it's the medical groups that are the problem. They would not approve going out of the medical group to a specialist so I had the surgery with a general surgeon, and the whole medical group lacks the knowledge for follow-up on this surgery. Make sure you stay connected here if you are in the same situtation. E-mail me if you would like. I do have some direct addresses for sending information to BC/CC. Good Luck
   — Kathy P.