RE: Keystone Health Plan West

[Guest guest]

Jack - Hi there! I have a Blue Cross policy through my employer (the

largest hospital system in Idaho) and I'm sorry to say that, for me,

Orthognathic Surgery is an excluded benefit, but that's just MY

predicament. Lots of Blue Cross policies do cover the surgery and

you will need to read your specific summary plan description for

more info. Or, you can call the HMO to find out what's covered. I

noticed you also have a BS plan #, so Blue Shield may be able to

provide you with that info as well. Good luck! Let us know your

specific coverage when you find out. (Also, if you have coverage for

the surgery now, make sure you will still have the coverage when you

are about to have surgery; some insurance companies like to change

their benefits without letting you know - sneaky!) ~~ Diane

> I enjoy HighMark Keystone Blue, An HMO from Keystone HEalth Plan

West,

> as my insurance provider. Im lookin at my card and it says I have

BC

> Plan 363 BS Plan 865. Other than that, I see no information that

> would help identify my insurance.

>

> My question is, has anyone had any luck/not had any luck with this

> insurance provider in getting covered for the surgery? I havent

> consulted with an oral surgeon yet, but I thought I'd ask here

first

> in hopes of finding someone whose been through it with my medical

> insurance.

>

> Even if you dont have my specific insurance, I'd like to hear

> something about how hard it is to get covered.

>

> Thanks,

> Jack

[Guest guest]

Jack,

I was approved by Cigna with no problems, on the first try. But then, a

year and a half later, they cancelled the authorization b/c they no longer

covered orthognatic surgery (the only oral surgery benefits were to have

wisdom teeth removed). I was unhappy in my job anyway and decided to move

on, so I didn't fight them on it.

My new insurance (AmeriHealth Administrators) approved my surgery, also

first try with no problems. I'm hoping that I don't have a repeat of my

experience with Cigna! Surgery is tentatively for the fall.

Take care,

>

>Reply-To: orthognathicsurgerysupport

>To: orthognathicsurgerysupport

>Subject: [Orthognathic Surgery Support ] Keystone Health Plan West

>Date: Sat, 25 Jun 2005 06:06:25 -0000

>

>I enjoy HighMark Keystone Blue, An HMO from Keystone HEalth Plan West,

>as my insurance provider. Im lookin at my card and it says I have BC

>Plan 363 BS Plan 865. Other than that, I see no information that

>would help identify my insurance.

>

>My question is, has anyone had any luck/not had any luck with this

>insurance provider in getting covered for the surgery? I havent

>consulted with an oral surgeon yet, but I thought I'd ask here first

>in hopes of finding someone whose been through it with my medical

>insurance.

>

>Even if you dont have my specific insurance, I'd like to hear

>something about how hard it is to get covered.

>

>Thanks,

>Jack

>

>

>

[Guest guest]

Yeah, something about Cigna, they were awful to me too. But

mysteriously, they posted record profits last year when they denied

my surgery.....hmmm....makes you wonder how many other people got

denied for legitimate things.

> Jack,

>

> I was approved by Cigna with no problems, on the first try. But

then, a

> year and a half later, they cancelled the authorization b/c they no

longer

> covered orthognatic surgery (the only oral surgery benefits were to

have

> wisdom teeth removed). I was unhappy in my job anyway and decided

to move

> on, so I didn't fight them on it.

>

> My new insurance (AmeriHealth Administrators) approved my surgery,

also

> first try with no problems. I'm hoping that I don't have a repeat

of my

> experience with Cigna! Surgery is tentatively for the fall.

>

> Take care,

>

>

>

> >From: " jackthomas1234 " <jackthomas1234@y...>

> >Reply-To: orthognathicsurgerysupport

> >To: orthognathicsurgerysupport

> >Subject: [Orthognathic Surgery Support ] Keystone Health Plan

West

> >Date: Sat, 25 Jun 2005 06:06:25 -0000

> >

> >I enjoy HighMark Keystone Blue, An HMO from Keystone HEalth Plan

West,

> >as my insurance provider. Im lookin at my card and it says I have

BC

> >Plan 363 BS Plan 865. Other than that, I see no information that

> >would help identify my insurance.

> >

> >My question is, has anyone had any luck/not had any luck with this

> >insurance provider in getting covered for the surgery? I havent

> >consulted with an oral surgeon yet, but I thought I'd ask here

first

> >in hopes of finding someone whose been through it with my medical

> >insurance.

> >

> >Even if you dont have my specific insurance, I'd like to hear

> >something about how hard it is to get covered.

> >

> >Thanks,

> >Jack

> >

> >

> >