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Author Topic: What insurance did you have when treated? I've hit a snag  (Read 1651 times)

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horse doc

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What insurance did you have when treated? I've hit a snag
« on: October 27, 2016, 07:02:22 AM »
Mine is BLue cross blue shield anthem. 

Dr. G office staff says resurfacing not covered when getting me preauthorized.  AAaaRGGGG!

catfriend

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Re: What insurance did you have when treated? I've hit a snag
« Reply #1 on: October 27, 2016, 12:31:49 PM »
Open enrollment is coming up. My suggestion is you shop for a new plan based on whether or not it will cover your surgery and doctors. Knowing I was going to have HR I obtained a top level policy with a 'low' deductible etc. Higher monthly payments, but worth it for having a major medical procedure.

blinky

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Re: What insurance did you have when treated? I've hit a snag
« Reply #2 on: October 27, 2016, 12:41:08 PM »
Good idea.


If you can't find a program that covers your resurf, these thoughts: 1) appeal. Your current insurance company probably has a procedure for this. Dr Gross has lots of good data for an appeal. 2) will they cover any aspect of the surgery? Can you separate out the hospital from the surgeon and other doctors? Maybe they will cover some part but not all. The hospital cost is the biggest fwiw. 3) Ask about Dr Gross' lump sum payment plan for people without insurance. I recall it isn't cheap, but is about the price of a small, luxury car.

jmorriss

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Re: What insurance did you have when treated? I've hit a snag
« Reply #3 on: October 27, 2016, 05:45:06 PM »
I'm surprised that Anthem doesn't cover resurfacing.  I have Anthem and had resurfacing with Dr. Gross in August 2016 and they covered it.

horse doc

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Re: What insurance did you have when treated? I've hit a snag
« Reply #4 on: October 28, 2016, 07:32:53 AM »
Update from the office.  The matter was taken higher up the food chain at BCBS and the medical director approved it.  YESSSS! (anthem virginia)

In the meantime I was looking into the option of changing policies etc.  What a mess it would have been and it would have blown my scheduled date

It's time to get serious about preparations, not much time now.  Thanks to all having given info and advice here

blinky

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Re: What insurance did you have when treated? I've hit a snag
« Reply #5 on: October 28, 2016, 07:52:46 AM »
Whew!

jmorriss

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Re: What insurance did you have when treated? I've hit a snag
« Reply #6 on: October 29, 2016, 01:03:54 AM »
Glad to know this has been resolved. 

 

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