Gunson Anthem Ins??

[DRG]

@ puglover - I see that you currently just five posts to your name. The magic number is seven, set by the Board Admin. Just post a couple more replies to qualify your account and you should be good to go.

DRG

[puglover]

Thanks drg so this is six lol

[double jawbreaker]

Did any of you read Wiki's post about Dr Arnett/Gunson and Cigna? Cigna's allowable is $22,0000! Wiki mentioned that translates to $15,000 of the surgery cost being covered. I finally got approvalfrom Anthem, but Dr. Gunson's financial adviser said the important issue is the allowable amount. This amount can be as low as a deductible. Can anyone share about Anthem's "allowable" amount.

[Marisama]

I have Aetna PPO. Does anyone have any info on Aetna with Gunson?

[double jawbreaker]

I finally received my Anthem allowable. They are willing to pay $645 of the surgery with Dr. Gunson after my deductible is met. This is a joke. Has anyone had any experience with appealing an allowable amount? I should probably start this as thread...

[puglover]

I finally received my Anthem allowable. They are willing to pay $645 of the surgery with Dr. Gunson after my deductible is met. This is a joke. Has anyone had any experience with appealing an allowable amount? I should probably start this as thread...

OMG!!!! Do you have an EPO or PPO? I have Anthem EPO. I hate insurance, it makes me want to move out of America

[double jawbreaker]

Puglover I have a PPO. Maybe EPO will produce a better allowable amount, or is the Anthem allowable the same no matter what you have?

[puglover]

I don't know if the allowable is the same or not. During my consult Natasha told me that my EPO wouldn't cover anything b/c they are not EPO doctors. But I told her I talked to my ins and they said if there are no drs in your area that are covered under the ins (closet one is in LA) then the dr can send an out of network referral and then get the same coverage as if he were in network...so I dont know but that scares me.

[double jawbreaker]

Puglover, I just saw your post. So did Natasha tell you the closest "in-network" surgeon is in LA? I understood there wasn't a BC/network surgeon in LA or OC. If this is true, then Natasha can make an inquiry to Anthem about a referral. This is great news. Now I just have to confirm that there are no "in-network" surgeons in my area.

[puglover]

my ins told me there are no drs in the area and said the local dr i choose can do some type of referral. but that doesnt necessarily mean they will cover much.