ANA Discussion Forum

General Category => Insurance => Topic started by: psmix on April 20, 2011, 02:06:06 pm

Title: Insurance Coverage for Eye Weight?
Post by: psmix on April 20, 2011, 02:06:06 pm

Can any of you with insurance through Blue Cross Blue Shield comment on coverage for eye weights and other related procedures? I'm planning to start with an external weight, and may consider an implanted weight down the line. Blue Cross told me that it would have to be submitted for pre-authorization to determine medical necessity. I'm not too concerned about coverage for the Blinkeze, since I think that's relatively inexpensive, but I would hope they would cover other, more expensive procedures if I need them. I know that specific policies differ, but would be interested in your experience.

Thanks.
Pam

Title: Re: Insurance Coverage for Eye Weight?
Post by: Brewers7 on April 20, 2011, 02:53:40 pm

BCBS covered my weight.

Title: Re: Insurance Coverage for Eye Weight?
Post by: Kaybo on April 20, 2011, 03:49:41 pm

I don't have BCBS, but in my experiences, they ate more willing to do the major implants/surgeries than the little, much more inexpensive things!

K  ;D

Title: Re: Insurance Coverage for Eye Weight?
Post by: PaulaT on April 28, 2011, 08:24:21 am

Would it hurt anything to submit it for preauthorization? Is there any costs involved to have your doctor submit for preauthorization (http://www.goldenrule.com/health_insurance/health/)? They'll either approve it or not approve it but you don't have to commit to it before preauthorization do you?

Title: Re: Insurance Coverage for Eye Weight?
Post by: lori67 on April 28, 2011, 11:06:09 am

There won't be any cost to do a pre-authorization.

My eye surgeon in TN said that none of the insurance companies he had worked with would cover the Blink-eze, but I know they cover the implanted weights.  Now, this was 2 years ago, so things might have changed.  He was actually on a committee at that time to get the insurance companies to cover the external weights because that just really got him fired up.  I can see why, if a patient needs it, insurance shouldn't be denying coverage for it.

But, the worst they can say is "no", so I would go ahead and ask.  You won't have to commit to anything - the doctor would have to file an actual claim when the procedure is done before insurance would cover it anyway.

Good luck!
Lori

Title: Re: Insurance Coverage for Eye Weight?
Post by: psmix on May 06, 2011, 09:30:10 pm

BCBS did approve coverage for the external weight. I'm glad they made a logical decision, since the external weight is the cheaper option!

Title: Re: Insurance Coverage for Eye Weight?
Post by: Jim Scott on May 07, 2011, 12:57:42 pm

Quote from: psmix on May 06, 2011, 09:30:10 pm

BCBS did approve coverage for the external weight. I'm glad they made a logical decision, since the external weight is the cheaper option!

Pam ~

Thanks for letting us know how that insurance question worked out.  Congratulations!

Jim