Anthem BCBS WL surgery excluded. Need advice

New to the board and actually live in Michigan.  The company I work for is based in Connecticut.  I have Anthem BCBS Lumenos coverage.  Weight loss surgery is specifically excluded in the policy.  I need and want to have RNY surgery but at this point I don't know where to start. A couple of the bariatric surgeons I have contacted won't see me until I am approved and my PCP has been of little help.  I have asked him to send a letter to the insurance company to start the process to get approval and all he did was send me a single paragraph letter that outlined my obesity and co-morbidities and stating I needed surgery. I don't know what to do.  Does anyone have any advice? Dave

Hi Dave,  Call the insurance company and ask questions. Thats what I did. If it doesn't cover the surgery ask why?? There might be a way to get around it. Like your medical issues. Diabeties, high blood pressure, knee and back problems,sleep apnea, heart  or lung issues. Sometimes the insurance will cover if these medical issues are considered life threatening. Your PCP would or should know anout that. I have BCBS  of New England insurance and they covered mine. Good Luck. Sarah

Hi Dave, The responsibility lies with your employer.  You need to go to your HR person at work and ask them to provide a rider to include  Gastric Bypass RNY into the policy. It's not that Anthem BCBS doesn't pay for it, (I have it, and it was paid in full) , it is the ins plan that the employer choses and pays for. Start there and see what happens.   Paula