Insurance Fear?

[theother_onefoot 122]

From reading through various threads, I had come to think that having insurance cover WLS meant that they would almost for certain require a 3-6 month mandated nutrition monitoring program. Is thinking this incorrect?

I am currently in the process of switching over to BCBS of Texas, and while I was planning on being self-pay with the hopes BCBS would cover part of the cost on the finding of a hiatal hernia.... Is it possible that they could cover the entire surgery without requiring a 6 month stall?

I've planned the surgery with a timeline in place between school semesters and my final Pre-Op appointment is supposed to be on July 31st where I make my full payment... There have been unforseen holdups with getting the insurance switched over but they for sure have all of my paperwork now and I'm just waiting on receiving my member information so I can give it to the surgeon's office.. I'm concerned that there is just not much time left now -less than a month until the surgery date- but is there at least a chance it could be not only approved in time but not require the extra stuff?

The cash price is not cheap, but as far as my health and getting my life back on track, even if insurance could cover the procedure I can't afford to wait another six months beyond what I already have. This isn't about impatience any longer. My mental and physical preparations have been made and I think I'd completely break down beyond a therapist's help if this was put off.

Any hope?

[samelton68 64]

You will need to call them and find out if there are exclusions to the plan for bariatric surgery and if no exclusions they will be able to send you the guidelines lined out in your plan

[Need4Change 26]

I have BCBS (FL) through my husband's employer and unfortunately it is a contractual exclusion on their specific policy. Luckily I have Medicare as a secondary and my surgeon is hopeful they will pick it up.

I hope your situation and outcome are better than mine. Good luck!

[KDM74 186]

I am changing companies in 3 weeks and our new insurance is BCBS of Texas. The new plan does not cover wls however that is likely the choice of my new company. Every employer can choice what to include or exclude from their plans. I am really glad I already had my surgery, but feel badly for a colleague who was hoping to start the process this fall.