Anyone have this problem?

I have BCBS/HMO Blue Choice. I have been told I meet the medically necessary guidelines but they have to verify that there are no updates to my policy that exclude gastric bypass surgery.......what the heck??????? (I have already verified twice that this is a covered procedure and in my certificate booklet it states it is covered if medically necessary.) They are having to request a certificate booklet from their own company (BCBS Human Resources) to verify this. Now if you ask me this just doesn't sound right, or am I wrong? Confused, Debbie

HOley cow. THey just like to make this difficult dont they?? I am having simular problems but havent gotten as far as you have. Good luck... Keep pushing them and hopefully they will aprove it very soon!! Ginger

Hi Debbie, E-mail me and I will send you the name and number of the lady that got might all worked out. [email protected] Martha

Hi Debbie, I responded to Ginger's post last night with the following information. If you have already confirmed that it was covered, and you have documented who you spoke to, etc., and NOW they say it's excluded, I would DEFINITELY call the insurance commissioner's office.... Here's the info from last nights post... We ALL know that BCBS has paid multiple times this year. There are certain regulatory requirements and notifications that insurance carriers have to make to their customers if they are going to modify or limit their coverage. I suggest you contact the insurance commissioner's office. Also, I would let BCBS of Ga KNOW that you are going have contacted the insurance commissioner. NO insurance company wants to have a red flag go up on them at the commissioner's office. Here is the info... Website: gainsurance.org (put www. in front of the address) Address: 2 Martin Luther King, Jr. Drive Suite 704, West Tower Atlanta, Georgia 30334 Phone: (404) 656-2070 Fax: (404) 657-8542 Email: [email protected]

I have the same insurance, Debbie! It doesn't sound right to me. I like the other suggestions! I think I might also call back and ask to speak to someone else. Keep us updated! Dazed (and confused a lot lately), Becky

I have BCBS HMO Gwinnett County Schools. I called them after 1 week they said I had been approved, however, they never sent me the approval letter, so I called everday for 2 weeks. Finally they got tired of me calling and sent me my approval. You know what they say, "The sceaky wheel gets the oil." Just start hounding them until they will do any thing to get rid of you.

Thanks for all the replies guys. I am just now reading them cause as soon as I got home from work today I had to prop up my leg and ice my knee down. I twisted it Friday and it's giving me fits. Thanks!!!!!! Debbie