help....new insurance
i recently got denied from Aetna insurance, (2nd appeal) due to my Doctors' notes.
on monday the company that i work for were bought out and i have a choice of enrolling into Blue Cross Blue Sheild PPO or EPO any ideas which would be better to go with? my other choice would be staying with Aetna and trying to submit again and pay Cobra premiums........how good is BCBS to deal with i should meet the requirements from being with Aetna, should be simular? any advice? got very little time to make this choice
Hi Pam- It took me 16 months to get approved by BCBS of IL. They changed their requirements so many times mid-stream I was very frustrated. Botton line is now they require a 5yr history of obesity( this can be verified from any visits to any of your Dr.s over a 5 yr period where they noted you were obese. It doesn't have to be from one Dr.), a 6 month medically supervised diet, co-morbid factors such as diabetes, hypertension, speep apnea just to name a few, and a psych eval. I was denied 3 times and finally won on my last appeal. Bottom line, I think it's a double edged sword. Whoever you go with, you just have to be persistent and fight for it. Good luck-I'll say a prayer for you.
Hi Pam,
I have blue cross blue shield ppo and I am going thru the process of getting approved. I will tell you that blue cross requires a 6 month supervised diet. I am on my 3rd month. I have not heard of EPO. so far i am pleased w/ blue cross. you might want to look on the insurance board for some info.
Kim
I have bcbs PPO and was approved the first time around. I just had to have my bmi under 50. So I had to lose 22 pounds. I had 5 years of med records and a letter from my primary dr that stated I had been going to weigh****chers off and on for the last 10 years and lost very little and the to only gain it back plus. I had surgery in bothknees which was caused due to obesity. I als have adult asthma. Any way with all that I was approver the firs time w/o problems.
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