BCBS or Coventry? - ThinnerTimes

Chickadee · 05-04-2008, 12:29 AM

DH starts a new job next week and has choice of 2 different insurance companies for health care--BCBS and Coventry.

BCBS page says under "noncovered" services:

• Treatment and monitoring for obesity or for
weight reduction, regardless of diagnosis,
excluding surgical operations.

Please tell me if I'm interpreting this correctly: I would pay to speak to a bariatric surgeon and start the process, and BCBS should pay for the surgery (if medically necessary).

Actually, both plans say "excluding surgical operations," but I haven't seen many positive posts about Coventry, so I'm really leaning toward BCBS. What do you suggest?

Thanks for your advice...I'm so happy I found you all!

Chickadee

tazchic · 05-04-2008, 12:37 AM

that is basically what my plan says. I have had to pay for all nutrition, supervised 6 month diet, surgeon appointments and the Psych visit, but the surgery is covered. I would just call the company to be sure. I did that and was told exactly where my choices were to have the surgery. Good luck.

VTMoondog · 05-04-2008, 09:00 AM

I'm insured thru my wife, who is a teacher here in Burlington Vermont....so we're part of a fairly large pool of people. Under our plan...which is the "preferred" benefits...which I paya higher premium for btw...my surgery/room and all of the pre-op stuff was 100% paid for...save the $15 co-pays every time I went in.
I think the level of coverage depends on what your insurance group or company negotiated with BCBS.
Best of Luck!

SCOTT

Chickadee · 05-04-2008, 09:01 AM

That's what I thought that meant.

Seems like all those other things could be spendy. I'll have to start saving for it. Meanwhile, I'll work as hard as I can to lose some of this weight.

Heck...maybe by the time I save enough money I'll be close to goal!

May 5 for you? How exciting! I hope everything goes wonderfully!

Chickadee

Chickadee · 05-04-2008, 09:05 AM

Thank you Scott!

May I ask you a personal question? Are you happy that you did it? You're not too far out from surgery yet...so you might still have unpleasant side effects and doubts...but I was just curious.

Thanks again...and congrats on all your weight loss before and after the surgery! It must feel amazing carrying around 60 less pounds.

Chickadee

VTMoondog · 05-04-2008, 09:15 AM

Happy? Well....I'm sure if that the right word at the moment, but, I'm sure of my decision.
I'm having days right now, where I shake my head....but, I knew this was part of it. Post-op is no walk in the park. I'm always just shy of nauseated, still dont have my stamina back, and eat alot of the same stuff every day....it sucks. But, I know this is temporary.
My wife had the surgery 3 years ago, so I know what I got myself into, and yes, I am glad I did it, even though it's not so pleasant right now.

-s-

Check wheter or not some of the pre-op stuff is paid for!!!!! things like an upper GI or scope cost some big $$$, and ought to be covered!!

tazchic · 05-05-2008, 03:06 AM

It is expensive, but since it isn't all at once you don't feel the pain as much.

Scott made a great point the upper GI, EKG, labs and things like that were covered.

Nutrition classes, phych visit, supervised diet, visit with NP and surgeon (at least pro-op), none of this was covered.

Good Luck!!

VTMoondog · 05-05-2008, 05:32 AM

I guess ( and I knew this) I have to consider myself VERY fortunate, that BCBS picks up the tab for everything.....everything....all i've had to pay so far are my $15 co-pays. There is a $200 fee for getting into the program...but...when you consider this thing is going to end up skyward towards $25 grand or so, its a paltry sum.
I've been saving all the BCBS stubs from the mail and am going to add it all up at some point and see just how much this all came to.
Don't you love our health care system?

-s-

Chickadee · 05-05-2008, 06:22 AM

I'll make some calls today to get some information.

I went out last night and bought some healthy foods and am starting my gazillionth diet today.

But, I really feel positive about it this time. I'm going to start walking today too.

Chickadee