Blue Care Network

Hi Everyone! I am new to the site. I am just starting my WLS journey. I have been to an orientation with the surgeon. It was GREAT! He is out of Owosso Memorial Hospital. My problem is that they stated Blue Care Network is the most difficult to get approved. I did some checking on the insurance web site. They state that Bariatric Surgery is considered preventative treatment so is not covered or only covered at 50%. It also says it must be at an approved facility. The closest "approved" facility is Hurley, I used to work there and I had family members as patients there. I will not go there! Any suggestions for BCN?

Hi Tina , and welcome to the michigan board. BCN is the hardest, i had to fight for a year for approval. First you need to call and make sure your plan doesn't have an exclusion. They told me 50% too, but you have a limit on what you pay, mine was $1000, but i had another insurance too. I only had to pay $60 for my psych evaluation and that was it. With all my complications my surgery was over $300 grand and bcn paid up . I ended up approved through an in person appeal, and i have only seen one person on this site approved without appealing. You must go to a center of excellence. I know i went to Harper and had dr webber. I'm not sure which other hospitals are approved though, you should check into that. What hospital is your pcp through? If you need any help let me know. Just don't get discouraged and keep on fighting, it's so worth it in the end. Hugs Linda

Thank You! My PCP is through Owosso Memorial Hospital. I was hoping there would be a Hospital in Lansing if I could not go to Owosso. I looked it up and there are only about 6 Centers of Excellent in Michigan. I am going to keep pushing it though. This is only the begining of my journey and I am not a quiter. What did you think of Harper Hospital? Tina

Hi Tina: I have to tell you...I had my surgery at Hurley and received excellent care. I am not sure what you saw or heard, but they treat their bariatric patients awesome. I loved Dr. Obeid, and he provided excellent care to me. Good luck on your journey, and I would reconsider Hurley. Just my opinion. Tracey

Hello! I also had have BCN. I am considered to be one of the luck ones because it only took me about 6 weeks to get approved. I got denied after the 1st 3 weeks but then it just happened. I credit most of it to Paula at Dr. Zeni's office at St Mary Mercy Hospital. She is just wonderful and works really hard to get people approved. I also think because I got approved just days before they switched over to the Center of Excellence program it helped me. I was never told about a 50% co-pay either. Mine is supposed to be covered 100%. After I was released from the hospital one of the Nursing Supervisors from BCN called me at home to make sure I was doing ok and that I had all my meds. She answered all my questions and told me to call her anythime. She also sent me a letter a few weeks ago wishing me good luck. They have been really nice. I may have a different form of BCN or different coverage rhan everyone else. I know it may be a little far but I would call Dr. Zeni's office 737-655-2692. They are wonderful and he has patients that come from all over. He even has patients that come from Canada to see hiim. He's such a great doctor and his office staff are the BEST. Best of Luck. Stacey B