What do you think?

I found out my husbands insurance is going to be wellmark. I went to the homepage that they had on a handout about the companies insurance and found this neat little thing that said.. "Wellmark Names Bariatric Surgery Centers of Excellence." When you click on that link it shows the surgeons I have chosen and only speaks good things. Would you take this as they don't have a problem approving the surgery?? If it comes down to it, depending on what happens with my appeal to titleXIX, I may have to use his insurance. Higher deductible but oh well.. Just wondered what all you good folks thought of that.. Tracie

Is this your husband's ACTUAL insurance policy or is it the policy of Wellmark (BC/BS)? Even though Wellmark itself may pay for WLS, the employee's company may have an exclusion. ~~Sherry E.D.D. of Child #2~~11/11/05

My husband just told me he talked to the Human Resource department person the other day and asked her about WLS and she said we'd just have to read the book to see what the guidelines were for it and go by them. Tracie

That sure is right. Where my dh was employed at had bcbs but his employer had a exclusion for wls. He has a new job now with bcbs ins. but his employer has the rider for wls. Get your hands on a benifit booklet asap and check it out. I'm hoping you will be covered. Cindy

Hi Tracie! My husband has BCBS through his employer too and as of Jan 1 they no longer covered gastric bypass. They made an exception for me though, luckily, since I had been through most of the testing in 2004. Your husband's employer will know if there is an exclusion or not. Be careful too because I am not sure but it might be considered a Pre-Existing condition whereas you may have a waiting period of a year or 6 months. Not sure though! I just know that BCBS does cover it but employer's can and do exclude the coverage...mainly due to it's cost. Good Luck!! Jen

Traci, I am on my husband's Wellmark BCBS thru his work. Luckily we don't have the WLS exclusion. I have Dr Coster in Grinnell (another Center of Excellence for Wellmark). I was approved within 2 weeks, no problem. So far, Wellmark has been easy to deal with. Don't hesitate to ask, if you have any questions. LoriW

Thank you for some reassuring news.. I'm hoping that Vermeer has not choosen to exclude this surgery! My husband did get good news today that his benefits will be in effect June 1st.. WOO HOO... so then I can actually get my gummy little hands on thier actual policy. I'm so excited for him and me! Thanks for all the info.. Tracie