Guest guest Posted May 1, 2001 Report Share Posted May 1, 2001 Judie; Do you mean Federal Blue Cross? If that's what you mean it's approximately $157 per month. I don't know what it would be for 'Individual Plans' or for another group coverage. You'll have to check your local office. Make sure and tell them whether it's Federal or not because the Federal plan uses a different phone number and representatives. hugs, gobo > Gobo, > How much does it cost monthly for Blue Cross High Option? Im thinking of switching..... > > Judie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 4, 2001 Report Share Posted May 4, 2001 Hi Gobo, Listen, I was wondering if I could pick your brain? You may have read my posts about being denied a consult with Dr Hess but being approved for a consult with Dr. Maguire. Well the insurance co. says they will approve the RNY but not the DS. But Tammy at the insurance co. said to go ahead (if I wanted to) and have Dr. Maguire make out a treatment plan for the DS and we'll see what happens on appeal. What do you think my chances are of an approval? I'm hoping pretty good since I got my foot in the door with a DS surgeon. Anyway, I noticed in another post to someone you mentioned you worked with insurance before (I think it was you)and if you wouldn't mind giving me some of your thoughts, I'd appreciate it greatly! Thanks bunches, Angel --- gobo yoemoe@...> wrote: > Judie; > Do you mean Federal Blue Cross? If that's what you > mean it's > approximately $157 per month. I don't know what it > would be for > 'Individual Plans' or for another group coverage. > You'll have to > check your local office. Make sure and tell them > whether it's > Federal or not because the Federal plan uses a > different phone > number and representatives. > > hugs, > gobo > > > > Gobo, > > How much does it cost monthly for Blue Cross High > Option? > Im thinking of switching..... > > > > Judie > > > ---------------------------------------------------------------------- > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 4, 2001 Report Share Posted May 4, 2001 Angel; An insurance company's willingness to pay for something that is outside the scope of what they normally pay is increased hugely if you can present acceptable medical evidence explaining why the teatment is medically indicated over and above the treatment they would normally agree to pay. [What a run-on sentence that was, huh?] In other words, you want to present them with evidence that shows, FOR YOU PERSONALLY, the DS is the better choice. Therefore, the reason can't be " because it's a better procedure " or, " it has a better outcome " . Those may me the reasons many of us (myself included) decided upon the DS/Switch but you need to prove to your insurance company that ONLY the DS/Swictch meets your needs. You need to prove to them that the RNY is not, in YOUR CASE a good medical decision. For instance, if your BMI is above 50, the DS really is the indicated procedure. I've also read reasons that doctors give that pertain to a person's eating habits. I am unfamiliar with what those reason would be. I worry about reasons based on eating habits sounding suspiciously like eating disorders. A doc can probably present this reason legitimately. I think that on Dr. Hess' web site, there are some lists that show the pro's and con's of each procedure. There's probably also web sites that help people to decide which procedure is best suited for them. If you check around, you'll be able to find the sort of info. I'm referring to. What I would do, is use all that info to build a case for yourself. I would advise against using the fact that DS patients lose up to 85% versus RNY patients only losing up to 65%. The reason I say this is that BC/BS is patently AGAINST covering anything that has anything to do with weight loss or obesity. The ONLY reason they cover bariatric surgery (WLS) at all, is because of all the health risks or co-morbidities. As far as they are concerned, actually losing weght is secondary to reducing one's health risks. If you want more help, please just email me. I'll jump in with you and do some research. hugs, gobo " Necessity is the mother of invention " — Wycherly: Love in a Wood, act iii. sc. 3 (1672) > > > Gobo, > > > How much does it cost monthly for Blue Cross High > > Option? > > Im thinking of switching..... > > > > > > Judie > > > > > > > ------------------------------------------------ ---------------------- > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 4, 2001 Report Share Posted May 4, 2001 Angel; An insurance company's willingness to pay for something that is outside the scope of what they normally pay is increased hugely if you can present acceptable medical evidence explaining why the teatment is medically indicated over and above the treatment they would normally agree to pay. [What a run-on sentence that was, huh?] In other words, you want to present them with evidence that shows, FOR YOU PERSONALLY, the DS is the better choice. Therefore, the reason can't be " because it's a better procedure " or, " it has a better outcome " . Those may me the reasons many of us (myself included) decided upon the DS/Switch but you need to prove to your insurance company that ONLY the DS/Swictch meets your needs. You need to prove to them that the RNY is not, in YOUR CASE a good medical decision. For instance, if your BMI is above 50, the DS really is the indicated procedure. I've also read reasons that doctors give that pertain to a person's eating habits. I am unfamiliar with what those reason would be. I worry about reasons based on eating habits sounding suspiciously like eating disorders. A doc can probably present this reason legitimately. I think that on Dr. Hess' web site, there are some lists that show the pro's and con's of each procedure. There's probably also web sites that help people to decide which procedure is best suited for them. If you check around, you'll be able to find the sort of info. I'm referring to. What I would do, is use all that info to build a case for yourself. I would advise against using the fact that DS patients lose up to 85% versus RNY patients only losing up to 65%. The reason I say this is that BC/BS is patently AGAINST covering anything that has anything to do with weight loss or obesity. The ONLY reason they cover bariatric surgery (WLS) at all, is because of all the health risks or co-morbidities. As far as they are concerned, actually losing weght is secondary to reducing one's health risks. If you want more help, please just email me. I'll jump in with you and do some research. hugs, gobo " Necessity is the mother of invention " — Wycherly: Love in a Wood, act iii. sc. 3 (1672) > > > Gobo, > > > How much does it cost monthly for Blue Cross High > > Option? > > Im thinking of switching..... > > > > > > Judie > > > > > > > ------------------------------------------------ ---------------------- > > Quote Link to comment Share on other sites More sharing options...
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