BCBS of Texas

[ShyTexRose 0]

I am in Dallas waiting on approval. I have been turned down before but the AIGB thinkgs the rules have changed and is applying for me again.

Has anyone else had success with BCBS of Texas?

[JasminesMystic 0]

Hi Love,

sorry to say I was turned down twice by BCBS, my last denial was in 2005, so maybe the rules have changed by now. I struggled with them for so long, I had time to save the $$$ for surgery myself and so I opted for self pay. BCBS kept stating they considered Banding experimental even though it's been approved by the FDA and there have now been 100's of thousands of surgeries performed. I'm alwas amazed (polite term) at how these insurance companies are allowed to make their own rules.:angry

[Kat817 19]

I too was denied by BCBS of TX, on a bogus loop hole! They have 3 major criteria you have to meet, BMI, and co morbidities being 2 of them. One of the criteria to meet was that you had to have 12 consecutive months of visits with the Dr. and supervised weight loss attempts. I had 10 1/2 months, and was in a car accident, and had to have knee surgery. They were refusing me because the 10 1/2 months did not count, I needed to begin again and do 12 consecutive months. God forbid anything happen 11 months into that year. They denied me twice, so I self paid in Mexico, ironically using my settlement from the above mentioned car accident! It was well worth it....shoulda done it from the begining, and I may be closer even to goal!!

Good Luck to you, keep after them!!! They did give Lap band it's own code so it is easier to approve now, they did that this year. The surgery was approved, it was me who failed to meet the requirements. I had years of documented obesity, but not with Dr. counseled weight loss attempts. I had all the WW, and diets listed, they could have cared less!!! They wanted him to counsel me in nutrition etc. The catch I am told is that if you actually lose while being counceled by the doc, you are denied!!!

Will be pulling for you!!!

Kat