mobroke 2 Posted April 9, 2019 Hello! I’m very new to this site and just beginning my journey. I am attending a bariatric surgery seminar next Monday to learn about my options for WLS & meet the surgeons. I have insurance through BCBS Arkansas, through work. Our outline of coverage says, “Services your plan generally does not cover,” and lists a bunch of services including bariatric surgery. Has anyone had ABCBS and appealed after a denial? I’m thinking that would be my best move, or wait 2 years until we switch insurance plans and hope that it’s covered under the new one. I’ve heard great things about BCBS, and even read a statement by them that says they believe bariatric surgery is vital to a long healthy life, etc. Yet, it’s not covered in my particular plan. I cannot even see a doctor or surgeon,(outside of the seminar next week) until I have approval from my insurance. Thank you in advance. Share this post Link to post Share on other sites
mobroke 2 Posted April 9, 2019 And I’m also considering gastric sleeve! So sorry if this was posted to the wrong spot, still new here😭 Share this post Link to post Share on other sites
KCgirl061 1,532 Posted April 9, 2019 Unfortunately if the policy that your job provides you doesn't include WLS then no amount of appeals will get that policy to cover it. Reach out to the Human Resources department to get a more specific answer than "generally doesn't cover" and if they don't, request that they consider including it next year when policies are renewed. Share this post Link to post Share on other sites
Briswife15 890 Posted April 9, 2019 I agree with KCgirl. Your employer has chosen not to include Bariatric surgery as part of what they purchade insurance coverage for. Definitely reach out to HR. An appeal won't work. Sorry. Hope you eventually get it covered and get your surgery !Sent from my SM-N960U using BariatricPal mobile app Share this post Link to post Share on other sites
mobroke 2 Posted April 9, 2019 Thank you both! I thought that would be the case. i received my packet of paperwork for my seminar yesterday after work, and there was a form included with questions to ask an insurance representative. He informed me that per my policy bariatric surgery is covered!😁 I’m super nervous and excited for this journey! Share this post Link to post Share on other sites
mobroke 2 Posted April 9, 2019 Not sure why I’m getting two different stories, but he said it was covered so I’m running with it! Share this post Link to post Share on other sites
Briswife15 890 Posted April 9, 2019 That's great! Ask for something in writing, like the specific coverage so you're not surprised later!Sent from my SM-N960U using BariatricPal mobile app Share this post Link to post Share on other sites
mobroke 2 Posted April 9, 2019 Yes! The rep gave me websites with information and our plans outlines as far as coverage and requirements! 🙌🏻 Share this post Link to post Share on other sites
Briswife15 890 Posted April 9, 2019 Awesome news!!!Sent from my SM-N960U using BariatricPal mobile app Share this post Link to post Share on other sites
Frustr8 7,886 Posted April 9, 2019 I c was on BCBS Arkansas when I worked at Wal-Mart, lo these many moons ago. Share this post Link to post Share on other sites
mobroke 2 Posted April 9, 2019 I read that most BCBS plans cover WLS, but in our policy outline for some reason it said that it didn’t cover it. But I called customer service today, and the rep answered all the questions on my sheet, and assured me that it was covered. Share this post Link to post Share on other sites