HELP Choosing!!! Kaiser or Blue Cross Pudent Buyer PPO

Hello, I will be posting this question on the plastic surgery forum, too. I have until Friday to decide to go with either Kaiser or Blue Cross Prudent Buyer PPO. I have looked at both of the medical benefit summary plan descriptions and both of them state they cover reconstructive surgery. However, I am wondering how many of these reconstructive surgeries they have actually approved. Is there anyone out there who has been approved by either one of these insurances for reconstructive surgery? This would truly help me to decide which insurance I will choose.   Thank you in advance,

http://www.surgerytoday.com/ Tammy Wu is in Modesto, AND she links back to OH.com. They do body contouring after bariatrics. You can probably email her office staff and they can help you. They answered my questions right away.

Hi Tina, I too am in Modesto. I don't know any information about the plastic surgery being covered but keep in mind you will not have to go to a Kaiser contracted facillity (in our area that is Emanuel Hosp. in Turloc****il the Kaiser hosp. opens) if you go with the Blue cross PPO. However with the PPO you will pay more out of pocket ( you usually have a deductible). With Kaiser HMO you will just have a co-pay. The co-pay is usually quite a bit less then the deductible). With Kaiser you will also need to use one of their primary care doctors and a surgeon that is contracted with them. So make sure you can find a good doc on the Kaiser provider list before you commit. If you know any nurses they can be a great source of info on the quality of a doctor, ask them if they would be one of his patients. If they dont say yes look for another doctor. It can get quite ugly getting Kaiser to pay if you do not stay in their contracted network. You will also wish to stay in the Blue Cross PPO network to maximise your benefits but almost all doc's seem to contract with Blue Cross. It will just cost you a bit more usually if you go out of the PPO network but you dont usually have to fight tooth and nail to get out of network visits paid as you would with Kaiser. I hope this helps you, if you cannot find the contracted Kaiser doctors online then call Kaiser and ask who the contracted doctors and surgeons are in our area. To see if your current doctor and the surgeon you wish to use are contracted with Blue Cross PPO just call Blue Cross and ask or call Blue Cross and give them the name of your doctor, they will look him up on the list and let you know.I have done medical billing for many years and have gained this knowledge. Again , I do hope it helps you. Kim B.