Bcbs Of Florida

[Diane626 1]

Hi everyone. I just started exploring the Lapband and had made the decision to go for it. I inquired with my insurance company and tis is the response I got back:

"Your plan specifically excludes : Weight Control Services including any Service to lose, gain, or maintain weight regardless of the reason for the Service or whether the Service is part of a treatment plan for a Condition."

I am employed full time and pay extra to have a better BCBS plan so I am very discoraged with this response. I am 61 years old, weigh 280, take meds for high blood pressure, take meds for Type 2 Diabetes, and both of my knees are extremely painful. I know my primary care physician as well as my orthopedic doc (who gives me shots in the knees for the pain) would definitely approve of this surgery and would write letters if it would help.

Has anyone received this kind of notice from their insurance and was able to finally get approved?

Thanks so much for any info you can give. I truly appreciate it.

Diane

[AJohnson05 21]

I have Empire Blue Cross Blue Shield through Healthy NY, which is an *** and I was able to get approved. I was on Blood pressure meds and my BMI was over 50 so it was medically necessary. That was the only way they would cover the surgery. The fact that you have high blood pressure and type 2 diabetes the insurance company should cover it. That was my concern going for the surgery and my surgeons assistant said even if i have to fight with the insurance company to get you approved i will because of everyone could go on a diet to lose weight they would but everybody cant. Once i was done with all the pre surgical requirements it took about 2 weeks to hear a response. I also needed letters from my primary doctor and my cardiologist that was sent to the insurance company to help with the approval.

Good luck to you and i hope this helps!

[Justme9786 50]

I don't have BCBS, but I know that when I tried to get approved they denied me and I fought for 8 months, had letters from doctors on medical necessity, had conference calls with their medical advisors at the insurance co, and finally they approved me. I wouldn't give up, I would fight for it if you can.