Hi ladies :D Any experience with BCBS?

  • AndreaDeeds
  • 2 years ago

Hello Ladies!   I am new here. A tiny bit of background: My name is Lexi, I'm 27, I'm 5'3", 130lbs., and a 32G/F depending on the brand. Although they have alwasy been a pain int he booty to fit into something I loved them when I was in my teens and early 20's, and I was a fitness instructor so I was able to stay fit enough to avoid back pain... Well life moved on and now I am a busy graduate student persuing my real passion.... and I barely get to the gym 4 days a week for an hour or so each time, let alone the 4-6/hrs a day I was logging as an instructor! Now the back pain has set in and has advanced rapidly... From a sore neck at the beginning of the year, to nerve pain and numbness in my left shoulder and arm sometimes now, as well as constant soreness in my neck, upper back, and shoulders.    I decided to go for it. I started meeting with surgeons and found one I adore and his insurance lady is turning in the paper work to Blue Cross Blue Shield any day now (consulted with him on Wednesday), and my primary care doctor wrote a note to accompany his as well. They both said approval should be a snap since I meet the minimum removal requirement easily (I think it's about 310 from each breast for my body surface size, and I want to lose a full 5 cup sizes and go down to a C.   There is one little bit on my insurance form that is bugging me though.... It says the pain must be documented for at least one year.... While I did see my doctor about the pain in Januray, it was while I was there for a regular physical and she didn't write that I asked about the neck and shoulder pain in my chart (grrrr). I have a feeling this might get me automatically denied, and I may end up in the appeals process.    As a poorish grad student there is no way I can scrape up 9G for the surgery myself past, well, pole dancing at night (lol), so I am really hoping praying for the insurance to go through...   Has anyone else had any experience with Blue Cross Blue Shield PPO? How long did it take from your submitting of documents to knowing someting? If you did have to appeal, how long did that take? Had you documented your back problems for at least a year?    Thanks guys! Any bit of info is appreciated! 

Comments (6)

I'm BCBS of Iowa
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No I am in Wisconsin
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DID EITHER OF YOU HAVE BCBC OF ILLINOIS?
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I had BCBS. Was worried that I didn't have a ton of documentation either and was worried. I sent in a letter from my primary care, as well as a previous provider, stating that my large breasts affected my quality of life and health. I also noted that I had tried massages and took Ibuprofen regularly. They didn't require any documentation of the massages. I received my approval in about two weeks. Good luck!! Keep us updated!
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Hi Lexi,
My insurance is BCBS also, and I had no issues at all. I never went to the Dr in the past for the pain I always just lived with it. When I went to my consultation my Dr took pics and my height and weight I am 5'8 and 140 I was a 34 DDD. I was approved within 3 weeks with no issues no documentation of past pain needed. They said they had to take 400cc out of each and my dr actually took 440 and 480 I think. I am now a 34D and I am 5 mo post op. They may still go down I am not sure, everyone says give it a year... So I hope you have as good of an experience as I did with the insurance all together my surgery was 30K and I paid total OOP 350.00. :) Best thing I ever did.
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Hi Lexi,

These two RealSelfers have BCBS (your review shows up too :). Check it out. Hope this helps!

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