BCBS STINKS!!!!!!!!!!!!!

Hello CT WLS Family: I am so upset. My doctor's office just called and said as of the first of the year 2005 there is a rumor that BC won't be covering the Gastric Bypass surgery. This is so unfair. They have no right to dictate who can have what. I will probably be going in December 30th since I was already approved this year. This really sucks for anyone that is waiting for their surgery next year. Hopefully if enough doctors complain the insurance company will change their minds. They should realize there are alot of people out there that need this surgery or they could die. This is so ridiculous. If anyone hears otherwise let me know, I would appreciate it. Kim Callahan Milford CT

May I ask what kind of blue cross. Is it Anthem, state of connecticut. Or federal BC, or some other kind. Im a state employee. If I need to hurry my stuff along I need to know.

Hi Kim, These rumors happen every year with every carrier. Some do change every year, but it's not ALL BCBS. Best bet is to call your specific plan and see what they say. Good luck!

check the posts from last week (I think) This rumor starts every year about the same time. What is accepted or rejected is mostly due to your plan specifics. Check those out first. Peter

Oh God....please please tell me that this is wrong! I've been working since Aug of 2003 to get this done and BCBS is still deciding on wether or not they will cover me. We sent in all the test reports and all the other stuff that they wanted back in July. They sent a letter back to me stating that I needed to have some psych test that hasn't been used in like 15 yrs. in mainstream psychology. So they've been dragging their toes. Now I guess I see why. On top of this I just found out from my Dr office that he is changing the hospital that he's working out of and will not be doing any surgeries until Jan 2005. Man this could really mess things up. I'm sitting here crying and just don't know what to do next. Talk to me folks, what do you think I should do next on this? Do I have legal options? I would appreciate the help. Thanks so much Heather R

I would call your individual plan - when this rumor started last week, I called Anthem BC/BS of CT and they said they had not even heard that rumor! I asked if she would know and she said most definitely so I am not going to worry about it. Call your info number - they should know since it is so close to yearly renewal. Best of luck! Nancy

Hello ALL I am working with Dr. Reinhold out of New Haven and they are pushing my dates up because I have BCBS PPO The Empire Plan. I called the insurance and they would not confirm nor deny. I will continue to call and get an answer. I do know that My doc is complaining to BCBS. Not sure if he would do that based on a rumor. Frenchy

I have empire blue cross as well. I wonder if we can get a letter from them indicating if lap band is excluded or not excluded from their coverage. I think I will try and call tomorrow. Please post if you hear anything. Have you gone through the process of trying to get approval yet?

Joanne, I also have Empire Blue Cross, they're based in NY. I had an awful time with them, they dragged their feet for week after week. Empire uses a contracted company called InterCorp for precertification and approval. They denied me twice, finally I had to result to a company appeals process that resulted in me being approved. They claimed that I didn't have the required documentation because it wasn't organized the way they wanted it. Translation - delay until the patient gets tired of trying. If you email me I can show you copies of the letters I sent and the responses if I still have them. They've also started to require 12 weeks or more supervised weight loss under care of a physician not associated with the bariatric surgeon before approval, and doccumentation of 5 years of weight loss attempts and methods. --Steve

Are you lap band or rny?