Bezy

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About Bezy

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  1. I hit a stall at week 2 and no loss since then (a week ago). No matter if you know it is likely to happen and are glad for the 13 lb loss in 11 days, it is very disheartening and a bit frightening ☹️
  2. I know you posted this about 9 months ago, but I found it very helpful. I am just now trying to pull together info to see if this surgery is a good choice for me. But I feel as if I am always in the small percentage group on everything (I had a 100 lb loss that took 3 years and at just over 5 years after I’m headed back to the start after such a struggle not to do so). I have Blue Cross Blue Shield of Illinois and also TRICARE (select/retiree/East) - from what I can see (and after talking to a rep from BCBSIL) their list of co-morbidities is short and only the few major ones. Although she encouraged me to have my endocrinologist send in some paperwork asking for an authorization, and suggested that Blue Cross Blue Shield would almost have to be in a little on Matt, it does have me concerned. I thought perhaps I might need to use both plans to cover the testing, etc. up until just before the surgery. Then possibly drop the Blue Cross Blue Shield if Il (that is through my husband’s employer) until after the surgery, picking it up again during the next open enrollment (I have not yet verified that is possible but I believe it to be). The rep encouraged me to have my endocrinologist sending in some paperwork asking for an authorization, and she hinted that with the co-morbidity list being so short without wiggle room it meant they would almost hsve to allow other syndromes/disorders in...?). The criteria may or may not be tougher for the bcbsil than the Tricare East, I cannot yet tell. I thought perhaps I might need to use both plans until just before the surgery. Then drop the Blue Cross Blue Shield would just think my husband‘s employer until after the surgery. And then pick it up again the next time there was an open enrollment the same year. I feel as if I am plotting battle (beforehand) and so any ammo is useful!
  3. The percentage the insurance company pays is based only on that usual and customary. But when a provider is out of network, they can charge you anything they want and so you pay the difference. Say you want to have a certain procedure and your doctor charges $2000 for that. Your insurance company (in their wisdom LOL) may say a fair price is 1000. So let’s say you have a 20% co-insurance -insurance pays $800. But you owe this doctor 1200 (it would have been 200 with an in-network provider). That is why having insurance that has good docs on their networks is essential. I hope that helps.