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Anyone here have BCBS coverage and know if implant will be covered under insurance?

Thanks guys

I got mine covered with BCBS. i think there are multiple options within bcbs and it will depend on individual policy. But for me it was approved without any issue

BCBS has many different plans/policies. Mine covered 100%. Check with your insurance administrator.

Agree it is plan (within BCBS) dependent, but all require records showing all other treatment options have been tried. Gather as much of those records and supporting documents as you can muster. I was denied 3 times and finally approved after I overwhelmed them with a stack of papers.

Pamen116 wrote:Anyone here have BCBS coverage and know if implant will be covered under insurance?

Thanks guys

Insurance is state controlled. That is unless you work for the federal government or are enrolled in a federal program such as Medicare. If you purchase your own insurance through the marketplace (Obamacare) You should have coverage. The policy may be like my old policy was though and be an exclusive provider plan. That is where BCBS tells you where you have to go for treatment. If the BCBS plan is through your employer then the employer may have had the coverage excluded to lower the cost of the plan. My experience with BCBS is they hate to pay for this device. But as I said insurance is state controlled and men in other states may have different views.

Pamen116 wrote:Anyone here have BCBS coverage and know if implant will be covered under insurance?

Thanks guys

BC/BS gave the go ahead for implant surgery Nov 16 2022. I just finished with my 2nd appeal as they are denying paying lol.
Between my surgeons office and a lawyer I consulted they all feel that eventually they will pay. Their last Board meeting was early December and haven't heard a word. Have all the proof in the world when they gave the go ahead and still haven't heard back from them.
My Dr has not asked me for the $30,000 yet.

Upon initial contact with BCBS administrators I was told it wasn’t covered. Then after getting the Drs codes for cause or need of the surgery, I called them back and told that it was covered. Dr ran it thru insurance a week or so prior to surgery and it also came back approved. But as others said there’s dozens if not hundreds of different BCBS plans. I live in Arkansas and my policy is BCBS of Illinois…. Go figure! Good luck with your insurance, but if you get the codes from Dr it sure makes it easier.

Any suggestions on which plans to get?

I’m in California.

Alex258 wrote:

Pamen116 wrote:Anyone here have BCBS coverage and know if implant will be covered under insurance?

Thanks guys

BC/BS gave the go ahead for implant surgery Nov 16 2022. I just finished with my 2nd appeal as they are denying paying lol.
Between my surgeons office and a lawyer I consulted they all feel that eventually they will pay. Their last Board meeting was early December and haven't heard a word. Have all the proof in the world when they gave the go ahead and still haven't heard back from them.
My Dr has not asked me for the $30,000 yet.

My path was similar. I needed several back and forth to get them to approve surgery, then multiple tries with claim submission before they liked the codes and agreed to pay. During the delay, the hospital got threatening and I paid about $30k out of pocket to maintain good credit during a new mortgage process. After codes were all to their liking, BCBS paid the hospital. Was another fun time to get my refund. They accept no excuses when you owe them, but how they can make em when they owe you!

Review the submitted codes with your Dr and surgery center to be sure they are correct.

California -- Blue Cross Advantage HMO. Covered.