Any experience with Blue Cross of CA?

[Guest guest]

Hi all .... have any of you had experience with an individual policy

from Blue Cross of CA, and obtaining authorization and coverage for

myomectomy? In my case, I just started with them, and am paying

higher rates for a " high risk " policy due to my fibroid as a pre-

existing condition. The policy states that they might not cover

treatment for a pre-existing condition for up to 6 months after the

policy starts; however, they'll give credit for being treatment-free

with a previous insurer (and I've had continuous coverage with group

insurance for many years without treatment for fibroid other than

annual exams and 2 ultrasounds). I'm hoping to schedule a myo

sooner than later and expect to be seeking insurance approvals

within the next couple weeks.

If you've had any experience with Blue Cross of CA, and could offer

me insights - or have had to deal with the issue of the wait period

for a pre-existing condition, I'd love to hear from you.

Thanks!

[Guest guest]

Blue Cross paid for 2 myos for me, although i didn't develop fibroids until long

after i first became insured by them

Any experience with Blue Cross of CA?

Hi all .... have any of you had experience with an individual policy

from Blue Cross of CA, and obtaining authorization and coverage for

myomectomy? In my case, I just started with them, and am paying

higher rates for a " high risk " policy due to my fibroid as a pre-

existing condition. The policy states that they might not cover

treatment for a pre-existing condition for up to 6 months after the

policy starts; however, they'll give credit for being treatment-free

with a previous insurer (and I've had continuous coverage with group

insurance for many years without treatment for fibroid other than

annual exams and 2 ultrasounds). I'm hoping to schedule a myo

sooner than later and expect to be seeking insurance approvals

within the next couple weeks.

If you've had any experience with Blue Cross of CA, and could offer

me insights - or have had to deal with the issue of the wait period

for a pre-existing condition, I'd love to hear from you.

Thanks!

[Guest guest]

Hi Miriam,

out of curiosity since I too have BC, did you have to come alot out of pocket

for your myo? I know it depends on the plan. I have basic PPO.

a

Miriam Goodman wrote:Blue Cross paid for 2 myos for me, although i didn't

develop fibroids until long after i first became insured by them

[Guest guest]

a..

Honestly, I can't really remember, and I was married at the time and I know my

ex took care of the bills. However, I don't think I did have to come alot out

of pocket. I have a PPO also. It may also depend on what state you are in. I

believe Blue Cross in the different states may be operated differently or

independently. I am in CA.

Re: Any experience with Blue Cross of CA?

Hi Miriam,

out of curiosity since I too have BC, did you have to come alot out of pocket

for your myo? I know it depends on the plan. I have basic PPO.

a

Miriam Goodman wrote:Blue Cross paid for 2 myos for me, although i didn't

develop fibroids until long after i first became insured by them

[Guest guest]

I know that my out of pocket expenses will be 25% of the " negotiated

rates " and expenses, but my policy also caps out of pocket for these

types of expenses (hospital stay, surgeon, doctors, etc.) at $4,000

in a calendar year. I have the PPO 1500 HIPAA individual plan, so

if you have a group insurance policy, your coverages might vary (and

could be better than mine).

[Guest guest]

Hi ,

I had an individual BC of CA plan. I stated I had fibroids on my

application and had no " pre-existing " dislclaimer in my policy.

Have you looked closely at your policy to see if they specified

" fibroids " ? Read the fine print--every last word of it , very carefully.

It may take awhile as I know the policy is many pages long. If

ibroids is not mentioned specifically,then in theory its not a pre-

existing disqualification. Your doctors surgical coordinator

should know more once they go to to pre-verify you. It may take

going to scheduling surgery before you know for sure what BC of

CA will do. (unfortunately)

If you are getting conflicting information, call BC of CA, and make

sure to note the time, date and name of their rep you speak to. it

could make all the difference in the world later on if they say

you're approved.

if they just won't pre-approve, can you wait the 6 month waiting

period?

Best wishes,

PS they covered my myo and most of everything, except the mri--

I had to still pay about $500.

> Hi all .... have any of you had experience with an individual

policy

> from Blue Cross of CA, and obtaining authorization and

coverage for

> myomectomy? e had to deal with the issue of the wait period

> for a pre-existing condition, I'd love to hear from you.

[Guest guest]

Hi Miriam,

I'm in Ca too. I'm familiar how insurance works, but was just curious. Thanks

though,

a

[Guest guest]

I have the same plan.

a

mlm9863 wrote:I know that my out of pocket expenses will be 25% of the

" negotiated

rates " and expenses, but my policy also caps out of pocket for these

types of expenses (hospital stay, surgeon, doctors, etc.) at $4,000

in a calendar year. I have the PPO 1500 HIPAA individual plan, so

if you have a group insurance policy, your coverages might vary (and

could be better than mine).