Anybody know when BC/BS PPO changed policy about WLS?

Does anyone know when BC/BS PPO changed......to where you don't need pre-approval for gastric bypass? Thanks.

I started the process in April 2005, and preapproval wasn't needed then - so sometime before 2005. Marie

I wonder if, because I'm self-employed and pay for my own insurance, and it's not a group, if that makes any difference????

Hi Patty, I had my GBP in 03 and I didn't need pre approval, BUT some do, If you have GM, Traditional, or Messa are just a few that I know of that had to get pre approval back then. Policies change all of the time. It is good to check with your HR dept. or call the no. on the back of your card to see what your specific policy says. Hope that helps---Toni

Oh my go****hat's been the big hold up for me, because my PCP wouldn't write the letter, so I had to get another doctor to write it, and I was told that wouldn't hold as much weight since I hadn't gone to the 2nd doctor for very long, etc., etc.. Boy, that makes me mad.....plus I agonized over writing my own letter that was five pages long and took me forever! Then I find out I didn't even need a pre-approval. whoa!......

I had my surgery in 2003 and I didn't need preapproval. I had BCBS Traditional through GM. Holly W

And I wonder if there's a difference between PPO and traditional. Because isn't it harder with Blue Care Network? Hmmm.......I feel like I've wasted a lot of time trying to get these letters done!

I would think so just because it's an HMO and in my experience they are worse with everything because you have to stay in network and need referrals for everything. I think that with a PPO as long as you are in network the coverage is higher but you have the option of going out of network if you would like but the coverage is less if you do. With traditional I think that you can see who ever and the coverage is the same no matter who you choose. Based on my experience I think that is pretty much the difference although I could be wrong. Holly W

Seee I am not ALLLways right

I had surgery last July and I had to have an approval. I would read your policy carefully. Most are similar, but I have heard that the 'powers that be' at your employer can change things on the policies.