Not Covered by Anthem or UHC.

[umonica 0]

I contacted both of my insurance companies; and both my insurance companys told me WLS are not covered under my plan.

1). Primary = Anthem BCBS Blue Preferred Primary Plus (POS)

As of 2004 they have an exclusion:

Related to weight loss or treatment of obesity.

2). Secondary = United Health Care Choice

They do not cover weight loss surgeries.

I can't believe it! Now I have to come up with a plan B.

I am so sad.

[Lioness81970 0]

The insurance company will tell you anything. Sometimes the right hand doesn't know what the left hand is doing. My insurance (UHC) said the same thing when I called in and I was banded on 11/25. What I sugest to you is to get a copy of your memeber rules and see for yourself. Go over it with a fine tooth comb and see if it is in the exclusions. If you have it in writing then you know for sure. Don't go by what someone on the phone tells you.

[Graceful One 4]

Good thoughts from Carmen.

Do you have your SPD (Summary Plan Descriptions) for both of your plans? That should state clearly whether it is covered or not.

I forgot to tell you that I was denied on the phone for the lap-band after my doctor authorized it. I called back to speak with a claims manager and found it was a mistake...

Also, speak with your HR representative and see if they can do anything if your self-funded to get WLS removed as an exclusion!

[umonica 0]

Great Advice, Thanks!

YUP.. I have both my benefits summary guide books and both of them list WLS under EXCLUSIONS. At lease for the PLANS I have so I guess I need to find out the plan that includes the WLS and switch to that plan.

My HR Rep is on vacation til the end of the month but I can't wait til she gets back. I know sign up changes to benefits plans for our company is in October...Looks like this is going to be a long process.. But I'm willing to wait and hang in there.

Once great thing is the support system. Wow! I love this site and all the support I get this makes the wait much easier..

Thanks to all of you for your replies, advice and encouraging words.