Carefirst Blue Cross Blue Sheild PPO

Hello Everyone! I was wondering if anyone has this type of insurance?  I called and asked if they covered the surgery and they said they do at 80/20.  Does this mean that I would have to pay the surgeons fee no matter who I go to?

Also, are they requring a 6 month diet plan from your pcp?

I have attempted to get apply for this surgery over a year ago and found out (after all the testing and going to appointments and everything) that they did not cover it because it was a small group plan.  Well now I am with a new company who has a large group plan and I have all my information that I had submitted before as well as a log of my food/ weight/ and excersize.  Just wondering if anyone has encountered any issues with themm.

Thank you in advance!!

Ann

Ann,

I was approved through Care First two weeks ago. I had NO problems getting my approval. All they needed from me was my BMI to be over 40 with no comorbids, 35 with 2. A Psych consult and a 6 month diet within the last two years(they just started this requirement January1st). I walked into my consult with my 6 month diet so all I needed was my psych consult. I got that and was approved two weeks after the surgeons office submitted it.

My plan is paying 100% after my inpatient deductible which is 150 bucks. So it sounds like your plan may be a little different than mine?

I also needed an approval letter which I fought over and you can read about in my profile.

Good luck,

Laura