daco525 0 Posted January 24, 2009 My employer is thinking of changing health benefits. As employees we currently choose between BCBS Horizon or Traditional Plan. I currently have BCBS NJ Horizon (PPO Direct Access). There is no weight loss exclusion on my current plan. I am told that they are eliminating the Traditional Plan and everyone will be on Horizon. Here is the concern: some people are saying that our present BCBS Horizon coverage could change. Does anyone know if there is actually a BCBS NJ Horizon plan that has a weight loss exclusion. I should be ready for approval for lap band in May. I can't imagine all of a sudden having a new policy with an exclusion. Are there actually alot of plans out there with weight loss exclusions. Share this post Link to post Share on other sites
kgloverii 0 Posted January 24, 2009 My employer is thinking of changing health benefits. As employees we currently choose between BCBS Horizon or Traditional Plan. I currently have BCBS NJ Horizon (PPO Direct Access). There is no weight loss exclusion on my current plan. I am told that they are eliminating the Traditional Plan and everyone will be on Horizon. Here is the concern: some people are saying that our present BCBS Horizon coverage could change. Does anyone know if there is actually a BCBS NJ Horizon plan that has a weight loss exclusion. I should be ready for approval for lap band in May. I can't imagine all of a sudden having a new policy with an exclusion. Are there actually alot of plans out there with weight loss exclusions. All plans include weight loss surgery. However, riders are often added to the plans to EXCLUDE WLS. It depends on your employers preferences. Every employer my husband and I have ever had, have had exclusions for WLS. :thumbdown: You can always call BCBS and have them look up your plan and find out if it is included. Share this post Link to post Share on other sites
KyBandChick 3 Posted January 24, 2009 My employer is thinking of changing health benefits. As employees we currently choose between BCBS Horizon or Traditional Plan. I currently have BCBS NJ Horizon (PPO Direct Access). There is no weight loss exclusion on my current plan. I am told that they are eliminating the Traditional Plan and everyone will be on Horizon. Here is the concern: some people are saying that our present BCBS Horizon coverage could change. Does anyone know if there is actually a BCBS NJ Horizon plan that has a weight loss exclusion. I should be ready for approval for lap band in May. I can't imagine all of a sudden having a new policy with an exclusion. Are there actually alot of plans out there with weight loss exclusions. When is open enrollment for your insurance? I think most companies have theirs in November and new benefits begin Jan 1 of the next year. If you beneift year is Jan 1 - Dec 31 then you would be covered through 2009 so as long as you have the surgery this year you are fine. Share this post Link to post Share on other sites
MacMadame 81 Posted January 24, 2009 Why don't you ask your benefits administrator if they are going to start excluding WLS when they change plans? Share this post Link to post Share on other sites