What should I do

Hi Everyone, I ve decided to go through with the surgery and here the problem: I signed up with BCBS about 2 months ago and the new doctor is telling me to reconsider my decision without asking me how I did on prvious attempts so he gave me 8 pages of guidelines(basically everything I ve done and failed).He said it s a pain and my insurance will not pay for it. I am very upset so I am turning to you my friends on this site to help me. _ Is is true that bcbs will not pay for the surgery _Since my policy is new how long before I can be approve _ Can anyone refer me to a doctor in the newark- hackensack area whose doctor is favorable the surgery ?

Dear Amah, I don't know anything about BCBS. Do you have a handbook from them? I would want to see what their exclusions are. As far as your doc... I'd tell him that if he isn't willing to help you, then you'll find someone who can. I would want to know exactly what he knows about the procedure..the pros and cons of it, the risk factors, etc. I think "not knowing" may be the reason he fears the whole process. Fill him in Some docs really are clueless about this procedure! Good luck!

Amah, have you called BCBS yourself to ask what their policy is on WLS??? I'm dealing with Dr. Garth Ballantyne, out of Hackensack University Medical Center, Hackensack, NJ. I found out yesterday that CIGNA approved me and my surgery is scheduled for 5/29. Good luck on your journey, Linda

Amah, I would contact BCBS and get their policy and find out what they require. If they have a web site thata a good place to start. I would do the research and then speak with your doctor and explain to him that you know that you have a grasp of the risks and rewards of having the surgery. I had to do this with my PCP and it worked. I'm in the process of getting all of my paperwork my insurance company requires for approval. The last time I saw my PCP he told me he recommended another one of his patients to my surgeon for WLS. Sometimes the PCP needs some education too.

Amah, I have Horizon BCBS/NJ Plus - I am 10 weeks post-op and was approved on the first try. Like the others have said, contact BCBS yourself and ask them. Good luck

thanks everyone for your kind words. I will try to educate my PCP and refer him to this site if I have to. Meanwhile I will talk to the insurance co. Thanks to you all.

Amah, I have bc/bs NJplus and I got approved in one day. The doctor I have is Dr. Garrison out of St. Michales in Newark. I did a lot of research on the web and he and his staff answered any questions. I did go through all of the certifications that the insurance company wants to see. That's a bit of a story in it's self. good luck, don't give up. You will make it. Warren Couch