d mixon 23 Posted November 5, 2012 For those of you with BCBS. Did your handbook spell out NO coverage for any weight loss surgery even if medically necessary. Mine does but I was wondering if I should try anyway Share this post Link to post Share on other sites
Traci J. 207 Posted November 5, 2012 It must just be your plan. I have BCBS Blue Options (NC) and they cover it all. I just got my approval today and am scheduled for 12/19/12. Keep trying, you can fight it. If they still won't cover, think about personal financing. From all the research I've done, it's definitely worth it! Good luck! Share this post Link to post Share on other sites
DayByDay 123 Posted November 5, 2012 For those of you with BCBS. Did your handbook spell out NO coverage for any weight loss surgery even if medically necessary. Mine does but I was wondering if I should try anyway I have BCBS and it says the same thing. There is no way WLS is covered. Sorry. (I'm doing self pay) Share this post Link to post Share on other sites
Jessica9190 127 Posted November 5, 2012 There are many different BCBS plans. Each one varies and you have to call. Some have exclusions specifically against it and some have requirements and restrictions. Share this post Link to post Share on other sites
d mixon 23 Posted November 5, 2012 I have BCBS and it says the same thing. There is no way WLS is covered. Sorry. (I'm doing self pay) Could y give me an idea of what ur self pay charges were Share this post Link to post Share on other sites
Losin4good 690 Posted November 5, 2012 Mine was excluded also. I called and called and researched. If its excluded, its excluded. Period. We finally had to look into self pay. It was $18,000 where we live. Or 1/3 of that in mexico. So we took a vacation Share this post Link to post Share on other sites
d mixon 23 Posted November 6, 2012 Mine was excluded also. I called and called and researched. If its excluded' date=' its excluded. Period. We finally had to look into self pay. It was 18,000 where we live. Or 1/3 of that in Mexico. So we took a vacation <img src='http://www.bariatricpal.com/public/style_emoticons/<#EMO_DIR#>/wink.png' class='bbc_emoticon' alt='' />[/quote'] It is 14000 here in Mobile,Al. I'm a little afraid of Mexico. Share this post Link to post Share on other sites
iggychic 1,405 Posted November 7, 2012 There are literally thousands of BCBS plans which differ according to employer specifications as well as state law. If your book is current and it says it's not covered, it's not covered. Mine covers at 40 + BMI with comorbidities. I was lower than that with no comorbidities so I knew I was going to have to be self pay. Self pay in washington was about $20,000 with all of the extras needed. One thing you want to know from your book is that if you do go ahead and do self pay, do they pay for complications from non approved surgery/procedures? Mine will be about half a million total we're thinking (we thought it was half that amount but it's still growing). Our insurance is so far paying even though they didn't cover the surgery, which is incredibly rare. You will want to know this because if they don't cover it and you have a complication....well can you afford half a million dollars?????? Share this post Link to post Share on other sites
d mixon 23 Posted November 7, 2012 Oh I'm sorry..hope everything goes well Share this post Link to post Share on other sites
jengal2012 3 Posted November 7, 2012 I have BCBS and my original handbook said no coverage. When a representative was at my place of employment, I asked and she said sometimes it is covered. So I went ahead and met with a surgeon and they felt it would e covered. I got my approval letter today. Surgery is scheduled for Jan 7th and they said it wouldn't be a problem to have approval so far in advance of the scheduled date. It never hurts to call your plan administrator and ask. Share this post Link to post Share on other sites
NewKezia 20 Posted November 7, 2012 I have excelled bcbs and my surgery is on nov 27 and is covered in full. Best thing to do is call the insurance company directly. Share this post Link to post Share on other sites
chris54 106 Posted November 7, 2012 I hve bcbs and had surgery on 10/29 bcbs I got thief policy and there were revisions to the policy. As a matter of fact bcbs approves faster than any insurance I seen on the boards. Share this post Link to post Share on other sites
NewKezia 20 Posted November 7, 2012 I got my approval in 2 weeks. Share this post Link to post Share on other sites
Di-Sleeve 8 Posted November 11, 2012 I got my approval sent in the morning and by the pm they called me to tell me I was approved! : ) Share this post Link to post Share on other sites