BCBS of KS

I've learned that my *wonderful* insurance will not cover ANY THING related to weight loss.  Once I learned that I stopped researching Lap-Band.  The other day someone was telling me that if your PCP 'orders' surgery like Lap-Band for what is essentially a co-morbidity such as HBP or Diabetes, etc. that the insurance provider would have to pay.  Is there any truth to this?  I'm naturally skeptical but cautiously optimistic.  

I've actually considered changing jobs so that I could change insurance providers but the place I was considering applying has BCBS of Nebraska so I'm not real sure that they'd cover it, either!  

Anyway, does anyone have experience with this type of thing that could offer some insight?

TIA!

Definitely verify your benefits, but typically, if weight loss surgery is an exclusion on your benefit plan, there is very little you can do to get your weight loss surgery covered.  Have you talked with your HR people about coverage at all?  Depending on the business you are in, some employers will look into covering weight loss surgery for the upcoming benefit year.  They key is definitely to be as proactive as you can and have a strong understanding of your benefits.
Good luck!
Kind Regards,
Kim Brown
[email protected]
www.bliscompany.com

I have suffered for years from BC/BS of KS's total exclusion of all WLS, too. Even with a letter from my primary care doctor listing my comorbidities in the request, it did no good. (That was around 2005.)  I am not aware of anyone getting WLS coverage out of them.  (If anyone has, I'd like to hear about it.)  My health just got worse, until I am now on disability and waited the years until I could have Medicare, which will cover it.  (Just to be clear on the difference, I was referring to Medicare only, KS Medicaid excludes it.)
I think the first person *****plied to your post spoke about the employer's choices in what to cover.  In many places around the U.S., that is the case, but I think in KS, BC/BS of KS does not even offer any plan the employer can pick that includes WLS, nor any such rider.  The employer would have to pick an entirely different insurance company. 
Please know other states' BC/BS plans sometimes do cover WLS. 

Thanks for your replies.  What I find quite funny is that there are a few Weight Loss Clinics or Physicians on their preferred provider list.  Does anyone know if BCBS of Nebraska covers WLS?  My niece currently has their insurance and she works with a woman *****cently had Lap-Band but doesn't know if she was self-pay or if insurance paid for it. 

I have BCBS--I am not sure if it is of Kansas or not.  I don't think it has anything to do with the insurance company itself, but what your coverage for your company is.  My company just started covering it last year, so I was lucky.  Once I started the ball rolling, it only took two months from start to finish to get the surgery done.  I had to compile some information, but it was relatively easy.  So the key is to find out the coverage for the company, not the actual insurance company. 

BC/BS of KS and had my surgery on 7-20-09.  About a year and a hal*****here was a large article in the KS Star about BC/BS re-considering their views on WLS. I work in a doctors office and the first of 2008 we started have patients with state BC/BS coverage coming in for referrals to surgeons as they had just learned their insurance now covered WLS.

In January of 2009 I called my insurance carrier, again BC/BS KS and was told that my policy not covered WLS.  What a surprise!  I was fortunate and had my Lap-Band on 7-20-09.  So, BC/BS of KS has been slow to come around but they are improving. 

Talk to your HR people, call BC/BS and ask how to file a complaint/appeal, whatever you can do.

Good Luck and keep faith.

"again BC/BS KS and was told that my policy not covered WLS." 

Do you mean "now covered WLS"?   Wow, if so, this is the first I have heard of this.   So BC/BS of KS paid the charges on your Lap-Band?

I have BCBS of KS and just snet and email asking if or when they might start covering WLS and got the response that they have nothing in the works to cover WLS, but when I got ready to check back and see if aything has changed.  This was just this week.

It's determined by each policy not by insurance company. It is less expensive to have that exclusion in it. If your policy has a bariatric exclusion then you are not covered. I have BCBS of KS and my policy covered it. I also work for a bariatric surgeon and we have a large volume of patients with coverage with BCBS of KS. Call the customer service number on the back of your insurance card and ask if your policy covers bariatric surgery, that way you will know for sure.
Hope this is helpful and good luck,
Connie