Has anyone faught Anthem and won?

[JLA1975 0]

I have Antem BC/BS of California.

I spoke with a sales liason who has helped me with many issues and he read my policy and informed me that it doesn't say yes and it doesn't say no as far as obesity treatment goes. It's kind of a gray area.

He said that it will have to go through the managed care department for approval and it will have to be viewed as medical treatment for morbid obesity but not just obesity treatment. :smile2:

I have the BMI (46) to qualify but at this time I don't seem to have any other comorbidities. I am living with chronic pain due to low back pain and a herniated disc much of which would be resolved if I lost weight. Not sure if that would count.

Anyway just wondering if anyone had to jump through hoops with Anthem and had success???

Thanks!

[Angie65 7]

Hi,

I have Anthem and faxed 65 pages of documentation and got appoved in 15 days. My surgery is schedule June 1st. Yesterday I found out from my doctor's office that even enough Anthem approved me my husband's company has an exclusion. NO bariatric surgery of any kind or reason. Now, I am self pay ($17,000) and very much in debt for the next 20 years. I think that I am worth it so, I am going for it. My BMI is 58 and I weight 356. I need this for my family and I with or without insurance. I wish you the best of luck.

[sil 0]

hi i was watching the news last night, i forgot what channel the lawyer,or advocate was talking about insurance an how people was denied. he said some people just give up after the insurance deny them.he says the best thing to do is appeal an they win the majority of their cases if only people would appeal. thats what the insurance company wants you to do, it was about a lady who had fribromiaga hope i spell it right. she was saying they would not pay for her therapy sessions because it was not medically necesary.he said if people only would appeal an take no for an answer when denied. hope this help.