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Just wanted to share a positive story. My doc submitted my packet to Anthem Blue Cross Blue Shield on Monday and we had approval in 24 hours. I kind of feel bad for bad mouthing Anthem previously for other issues ;-)
So, I know it isn't the case for everyone, but thought I'd share for other Anthem BCBS folks!
Starting Weight: 357 Surgery Weight: 312 Goal Weight 157 Surgery date August 21, 2013 Current Weight 302 
But then on the day of the surgery I will have to pay about 2k of pocket. My insurance is going to pay the rest.
This may be a silly question.
Assuming insurance approves me to have WLS...
Do I have to pay the difference from what my insurance approves BEFORE my surgery. Or do they bill me for it afterwards?
Just trying to get my ducks in a row.
Thanks!
Laurie
Sleeved 6/12/13 - 100 pounds lost to get to goal!
Sorry for replying late! I have not been on in awhile. I ended up calling and they said WLS is excluded from my plan. I feel as if I have hit every possible dead end.
Thank you for the information!
"BMI over 40 OR 5 years documentation AND 21 years of age or older."
I truly hope that is the case. It seems to me since I had to call my HR dept to get the website and then log onto it with my social, that this is what my pre-requirements would be. It also states in the beginning of the literature that if there are any other that this one would over rule.
Laurie
Sleeved 6/12/13 - 100 pounds lost to get to goal!
http://www.obesitycoverage.com/insurance-and-costs/am-i-covered/check-my-insurance/item/kaiser-permanente-weight-loss-surgery-criteria
Mz. Scarlett.... I agree with almost everything you said, except for the fact the part about the insurance having nothing to do with weight loss surgery being a written exclusion but rather an employer issue. I have been battling with my insurance for EIGHT YEARS NOW!! My employer is onboard and has done EVERYTHING possible to try to have coverage for WLS included in our policy. In battling this, we have been told our insurance company does indeed have a package for bariatric surgery/treatment that is available at an extra cost. However, it is available only to employers with 50+ employees. There is nothing in place for those small employers, like single physician offices, etc. We have tried every route possible to try to get this over-turned with no luck. If you have information that would help me force this insurance company to provide the same options at a cost for us, I would definitely love to hear from you. With that being said....I too am hoping and praying for the single-payer program in Oregon!
Hockeymom87 · 0 replies · 729 views
