Question:
Does anyone from Arkansas have Blue Cross of California PPO insurance?

I am going to a Weight Loss Surgery Seminar on January 31, 2003 in Little Rock with Dr. Mark Gibbs. I have been researching for over a year now and I am ready to start my journey. I am very scared that insurance won't pay. I know it must be medically necessary with BCBS of CA, I was just wondering if anyone has this insurance and had any problems with getting approval. I have a BMI of 40.035. I have back pain, acid reflux, swelling legs and ankles, but no major co-morbidities. Over the last 12 years I have lost and regained about 120 pounds. Any information on BCBS of CA would be great. Thanks for your help.    — JENNIFER K. (posted on January 22, 2003)

January 22, 2003
I don't know how it plays in Arkansas or how an Arkansas doc will play with BCBS CA but in California, it is the best insurance you can have. Approval over 40 BMI is almost automatic. My approval in CA was 24 hours. If you have PPO you can go outside the network and they will pay 60%. However, everyones "maximum out of pocket expenses" are different. You might be able to stem the tide on that. I talked to BC about 5 different times with the same questions to be sure where they stood and how my deductible/out of pocket expenses worked. Call them and write down everything they say and ask for names. Then tomorrow call them again and ask the same questions and write down the answers and who you speak with. I did this 5 different times to be sure. They're easy to deal with so call them!
   — susanje

January 22, 2003
I live in VA and they are my insurance carrier. I more than qualify but the denied my because they consider the DS investigational. I have just started the appeal process I'll keep you posted.
   — davesband1

January 22, 2003
I too have BC of California PPO. I live in California and i had not problem getting approval right away. My BMI was only 38. But I had sleep apnea and the approval was no big deal. They paid all but $350 to my surgeon. And they paid all but $1400 to the hospital. I thought this was great. Making payments to both hospital and dr with no problems. I hope this helps..Good luck.
   — patti R.

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