insurance help in illinois please!?!?
Hi there, I am looking in to having this prodecure done here in chicago at the iniversity of illinois and ive come upon an unusual cur****tance.... My new company has allowed me the choice between a few different insurance companies! which are blue cross ppo/ blue cross hmo/ aetna ppo
and POSSIBLY humana i have to see if thats qualifying in this state. Id like some input on which on of this i should choose because depending on approval stats, im going to go because thats my biggest concern healthwise and initially i was going to choose blue cross, but last year while unisured i held them as a private insured and was hospialized 5 times freakishly and was dropped and left all to self pay. Im not happy with them, but I know they are a good company and if they are willing to cover the cost of this procedure id love to go with them. I am 26 years old, i have been diagnosed with high blood sugar/borderline diabetic/ i have PCOS/Insulin resistence/and pseudo tumor cerebri also known as IIH. Any help would be greatly appreciated!
and POSSIBLY humana i have to see if thats qualifying in this state. Id like some input on which on of this i should choose because depending on approval stats, im going to go because thats my biggest concern healthwise and initially i was going to choose blue cross, but last year while unisured i held them as a private insured and was hospialized 5 times freakishly and was dropped and left all to self pay. Im not happy with them, but I know they are a good company and if they are willing to cover the cost of this procedure id love to go with them. I am 26 years old, i have been diagnosed with high blood sugar/borderline diabetic/ i have PCOS/Insulin resistence/and pseudo tumor cerebri also known as IIH. Any help would be greatly appreciated!
BCBS is the largest carrier for med insurance in I believe all of Chicago Land. My PPO with them at work is a very generous policy due to the fact that the police officers have a collective bargining unit and the civilians receive the same benefits. It covered both my surgery and my DH's 5 years ago but that was before they started the months and months of doc supervised diet.
My DH's retiree insurance is with Aetna and the POS he has is pretty good but it did not cover his WLS because they changed the carrier afterwards. I will say do not go with Cigna because that is who he had pre op and he was denied even though he had a bmi of 55+. I will tell you that it (Aetna) covered his panni removal and hernia when he was 2 years PO and they were not the insurance that covered his WLS, go figure. When they approved him for the PS and hernia we said go figure and got it done right away before they changed their minds. I do think that while you are under the group policy with your company they do not take into consideration the prior med/ins issues. Everyone is covered even with prior medical conditions barring cancer or something really serious.
Chris
My DH's retiree insurance is with Aetna and the POS he has is pretty good but it did not cover his WLS because they changed the carrier afterwards. I will say do not go with Cigna because that is who he had pre op and he was denied even though he had a bmi of 55+. I will tell you that it (Aetna) covered his panni removal and hernia when he was 2 years PO and they were not the insurance that covered his WLS, go figure. When they approved him for the PS and hernia we said go figure and got it done right away before they changed their minds. I do think that while you are under the group policy with your company they do not take into consideration the prior med/ins issues. Everyone is covered even with prior medical conditions barring cancer or something really serious.
Chris
Open RNY May 7
260/155/140
I have BCBS HMO Illinois and when I went for an initial consult with the RNY surgeon and told the bariatric nurse/intake person my insurer, her face lit up and she said, "Bingo! They will cover you for sure!" They are evidently very pro-WLS if you meet the standard criteria. My primary care physican is the one who suggested bariatric surgery to me, and everything has been covered 100% (except a $20 copay for psych evaluation--per my policy). I have been VERY pleasantly surprised by HMO Illinois' cooperation and efficiency in approving. About three days after my final preliminary test (upper gi?) I got a letter in the mail saying I was approved. I did not need to do a six month supervised diet or anything--they accepted my PCP's record of weight loss attempts over the years.
But I'm sure it's a good idea to take a look at your particular policy.
(my surgery was done at Evanston Hospital and my network is ENH)
But I'm sure it's a good idea to take a look at your particular policy.
(my surgery was done at Evanston Hospital and my network is ENH)
i called both insurance companies, they refused to give me ANY information regarding what they cover until i sign up for their policy. I do not want to pick a policy until i KNOW this procedure is covered,My company has 15 diffrent policies to choose from, i have less then 2 weeks left to choose. I called HR they told me to call aetna and BSBS to ask because our policies because our company is nationwide wary from zip code to zip code. theyre clueless.
If getting infro from an insurance company is this frustruating now i can imagine what the process or approval is going to be like....
im torn between blue cross and aetna and i say that because blue cross dropped me last year as a private insurer because i becaeme very ill with a rare disease ....
im afraid now that im with a compant they wont cover the suguery because of all the hssel i had with them last year.
If getting infro from an insurance company is this frustruating now i can imagine what the process or approval is going to be like....
im torn between blue cross and aetna and i say that because blue cross dropped me last year as a private insurer because i becaeme very ill with a rare disease ....
im afraid now that im with a compant they wont cover the suguery because of all the hssel i had with them last year.
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