Just Informed

So we were just informed by mail that our insurance is changing from UHC to anthem blue cross. Lord knows I don't know how this is going to affect my biatric checkups. :confused: anyone here have them?

I do! Anthem requires that you do a psych evaluation and meet the minimum criteria for surgery. They will then require that you have the procedure at a Bariatric Center of Excellence with an in-network surgeon. The anthem website lists where those are. I started by calling Anthem and asking for direction. They were very good at explaining the process. Once I found the hospital. They told me what surgeons practice there. I then called all the surgeons and found the ONE that was in network. (I'm excited that he's great!) I then went through all the clearances that he required for me: Pulmonary, Gastroenterologist, Endoscopy, Labs, PCP clearance, nutrition classes and psychiatrist. Whole process took me 3 months. 

You can do it!

The OP is post-op. 

I have Anthem BCBS... I have not had ANY problems with them, whether it was related to my WLS or any other service I had performed.  I dont/didnt have to jump through hoops for services.  Everything in contract/benefit summary is pretty well spelled out and easy to understand. When I was considering the WLS, the customer srv rep emailed me the entire portion of the contract regarding WLS and what requirements were needed... Very good customer service. I know for the procedure itself, you need to use a Center of Excellence.  I would call them and find out if your surgeon/facility is a center of excellence.  If so, then everything should be fine.

The OP is post-op. 

You should call your surgeon and see if he takes the new insurance. 

I have Anthem.  My follow-ups/check-ups haven't been an issue at all.  The only thing I've had trouble with is that I constantly have to remind them that my surgeon is in-network and get them to review/change the claim to reflect that fact. 

As Gwen said, the only way to know is to find out if the surgeon is on the new plan.  My company is changing from BCBSTX to UHC and my surgeon is not a preferred provider for UHC and has no intention of doing so.  The office manager said they would take my copay and whatever the insurance would pay, which for out of network will probably be zero until the deductible is met.

I will see if they are truly willing to accept only the deductible else I may find another surgeon to monitor progress.  I have 1 more followup before the end of year and then not again until April.

BTW, the only way to be sure if the surgeon is in network is to get the provider number that they bill under and then call the insurance company.  Anybody that is pre-op should do this anyway.  You just cannot be too careful with these billing issues.

There is also something called "continuation of care" where you can keep your old Dr for a while. I am not sure if it applies here, but I've heard of it for like when the Obstetrician leaves the network in the middle of following a pregnancy. You should look into it.

My insurance is changing from Empire BC/BS to Anthem. Im pretty sure I had Anthem back in January as well as a lot of the paperwork already said "Anthem". At this point, depending on your exact plan, the surgeon is really just a specialist at this point. My particular plan does not cover nutrition visits. Definitely check to see if you need to have referrals though. Other than that since the surgery is done, these are really just regular doctor appointments.