Travel costs and insurance...

[Mermaid]

Does anyone know why California's Blue Cross Medical policies have coverage for travel costs to a qualified bariatric surgeon and/or center of excellence but other states do not? This is the same coverage offered to transplant patients in California.

Has anyone outside Cali had any luck having travel costs to an out of area surgeon covered? (Not including FSA reimbursements)

My state has travel costs for transplant patients but no other travel expenses are covered. Even with network insufficiency being an acknowledged issue.

I'm just annoyed. I don't expect anyone to fix this. I may have spent too many hours today writing appeals letters. (Thank go for Larra and Diana!)

 

[DianaCox]

There is a simple reason - the specific BCBS plan (not all of them do) requires that the surgeries be done at one of two BCBS bariatric "centers of excellence [or expertise or whatever bullshit term they use]" in order for the surgery to be covered - in other words, limiting their patients' access to their surgeon of choice by limiting the hospital where it can be done. CA law also requires that if the patient is more than 50 miles from the closest qualified doctor, travel expenses have to be covered. So the policy REQUIRES most CA patients to travel (our state is very big), and therefore the travel policy is included in that section of the BCBS policy.

You should look carefully at your EoB and see if travel costs are covered if they don't have a qualified in-network doctor within 50 miles or some specified distance. And check your state laws too. But CA is very patient/consumer-friendly.

 

[southernlady]

I know my husband's United Health Care policy (provided by GE while he was still covered for two years after being medically retired) covered his travel for his DS from TN to NYC. The policy was written thru NC for that division.

So it also depends on how the employer has the policy written.

It's not just a CA thing. And not just BCBS.

BTW, my Medicare Advantage policy thru BCBS TN would have covered travel if I had not been able to find a DS surgeon in TN willing to do the DS on a lightweight.