Blue Cross Blue Shield Illinois PPO

Fotchi · 06-26-2007, 09:50 PM

Hi everyone,
I am a noob to this board and have been a bit or a lurker. Anyways has anyone had any experience with BCBSIL PPO and getting approval for LAP-BAND®?

Are they going to expect me to jump through hoops or is this going to be a rather pleasent experience?

Thanks for your help

jennyd · 06-29-2007, 07:32 PM

WELL I JUST GOT MY INSURANCE FROM BCBS IL AND WONDERING IF ANY ONE HAS THIS INS AND HAD NO PROBLEMS WITH THEM COVERING THE LAP-BAND® :help:I NEED TO KNOW WHAT THE STEPS ARE WITH THIS INSURANCE IT IS PPO SO HOW IS IT....

Fotchi · 06-30-2007, 09:43 AM

Yesterday I talked to the person that does the paperwork with all the insurance companys and she told me I am covered. Now all we need to do is find out what they request before I can get this done. So at least we know BCBSIL PPO does cover LAP-BAND®.:clap2:

jennyd · 06-30-2007, 12:34 PM

:)now what did you go thru to get it aproved meaning the steps.thank you this gives me hope to know that bcbs il will do it

Fotchi · 06-30-2007, 12:45 PM

For me it was real simple. I just gave the coordinator all my info and she did the leg work. I went to the seminar on Tuesday and by Friday they let me know I was covered. Like I said in the earlier post I am not sure if or what they are going to require of me before I can get this done. Hopefully it wont be much of a hassle, but it seems to be going good so far.
I am very blessed to have a company that still has top notch insurance coverage for its employees.

jennyd · 06-30-2007, 11:24 PM

what is your deductilble for the bcbs il ins have they told you yet what is coming out of your pocket

Fotchi · 07-01-2007, 11:23 AM

I am fortunate to have a 200.00 yearly family deductible. Needless to say with kids this gets taken care of in January. My primary Doctor sent me to this place so I assume it is in network. If it is in network I will be covered 100%. If it is not in network then I will need to pick up 20% and the insurance gets 80%. I do believe the most that I would have to pay out of pocket for out of network is 2500.00 as that is what is written into the plan. So we will see.

sallen21 · 07-06-2007, 02:42 AM

Blue Cross Blue Shield of Illinois Obesity Management Web Site for Providers

I am considering LAP-BAND® surgery and I found this through an internet search. I will have BCBS of Illinios as of Aug. 1st.

I am just wondering how long I will have to wait since it is new insurance. I had previous insurance.

If anyone knows, please post.

Thanks

short1 · 07-08-2007, 11:18 AM

Fotchi,
I have BC&BS of IL. PPO type and was approved in about 4 weeks. They required a thyroid test which your family doc. can do, a psy. eval, a referral letter from one of your Dr., and a BMI of 40 or above and be 100 Lbs. overweight. Your BMI can be 35 or above if you have comorbidities (sleep apenia, sugar, arthritis, among other things). Call and ask for a list of exactly what the want. i went overboard and gave them years worth of files. Good luck. Oh i saw a dietician, but can't remimber if they said to or if I thought it would look good. :)
JP

mikeomando · 07-09-2007, 12:46 PM

Hi everybody!
I was banded 1/10/2007 at Northwestern in Chicago. I have BCBS of IL PPO. I was turned down the first time I applied for LAP-BAND®, and told I had to have 12 months of failure on a doctor supervised weight loss plan. I went with the Wellness Center at Northwestern, and started the process. Half way through the 12 months BCBS of IL changed their requirements to 6 months doctor supervised weight loss. I was approved after the coordinator submitted my paperwork. They don't make it easy, but their rules are pretty straightforward, and once you satisy the requirements, you should be approved. Most of the dietician visits during the 6 month program were not covered by insurance, so I had some expenses out of pocket.
Good luck!
mikeomando

Northern Mist · 07-14-2007, 11:04 AM

Hi All,
I was wondering if fills where paid for by BCBS of IL.? I'm not sure what flouro is but is this part of the fill covered? I have to save and budget so any information would help.
Thanks

jennyd · 07-18-2007, 09:55 PM

WELL I JUST GOT APPROVED FOR THE LAP-BAND® IAM REALLY EXCITED AND NOW JUST WORRIED ABOUT THE DAY CAUSE I HEAR STORIES ABOUT THE PAIN IN THE SHOULDER ....I HAVE BCBS IL:whoo:

Northern Mist · 07-18-2007, 11:14 PM

Hi Jennyd - Glad you got approved! How long from the time your paperwork was submitted did it take? I'm pretty sure the surgeon's office will have my paperwork turned into BCBS IL in a couple weeks.
Do you know how much fills cost? and if BCBS IL pays for them?
Thanks!

jennyd · 07-18-2007, 11:55 PM

i was approved in 24 hours and no i dont know how much the fills cost just yet i will find out monday i got my first appointment and then thursday i meet the doctor so i will let you know but to be honest with you i am going thru a differrent program down here in houston they got a better aftercare program cause my sister had hers there ....

Northern Mist · 07-19-2007, 09:55 PM

Thanks - I'm looking forward to hearing about your doc. visit etc...
Take care!