Question:
Switching from Kaiser Hmo to BC/BS PPO.. Will I be able to get it more easily?

Hello, I am switching from Kaiser HMO to Bc/Bs PPO sept 3rd. I'd like to know if It'll be harder for me to get approved with BC/BS then it was with Kaiser.    — AliciasMommy (posted on August 31, 2002)

August 31, 2002
I have NJ BC/BS PPO. I had to send them a letter from my PCP stating the medical need for the surgery, and I was approved in three days. I wrote the letter myself for my PCP, which she re worded a bit and faxed to them. If you'd like a copy of that letter, just e-mail me. I'll be happy to send it to you to use as a base. Joanne
   — Joanne B.

August 31, 2002
Be sure you read the exemptions. I have BCS PPO and it says it is not covered not even if it is medically neccessary, so please read it first. Also if it does say that it is not covered, get PCP to find a loophole and have them refer you. My PCP says you can get around it.
   — Stephania H.

September 1, 2002
I have BCBS Federal PPO. I had no trouble with approval for Roux-en-Y. Needed to be 100lbs overweight and a letter from PCP saying surgery was medically necessary. I have NO co-morbites and was approved in three weeks. 2002 coverage package has WLS listed as a covered procedure. This was last May.
   — Mimi R.

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