Calling all KY Anthem BC/BS people!

To those of you who have Anthem I have a few questions!

Is WLS covered?  More specifically, is the DS covered? 

Was it hard getting approval?

Is there an exclusion I need to be aware of?

My employer is considering this as our new insurance, and have roughly a week to decide, so I need to be ready to approach them with this.  This was all thrown on me today, and they are very active in finding an insurance that covers WLS for me!

Thanks!
D

I have Anthem Senior Advantage and they would only cover either gastric banding or gastric bypass.  But mine is a managed Medicare plan, so yours may be different.  Maybe you could call Anthem directly to see if they have any policies that cover DS.  If they don't, then whatever your boss gets wouldn't, either.

I was denied the first time and had to appeal - it was approved within 30 days after the appeal.  They may also want you to go on a doctor-supervised weight loss program first.  Best to check.

Jan

D first of all you need to find out if this plan that your employer is going to contract with Anthem if the contract has WLS coverage.  That is the main and most important thing you need to find out. 

Asking individuals on the forum if WLS under Anthem can't be answered as each policy written by a insurance company for employers or even individual plans have their own unique benefits.

So you should  first contact your HR department to find out what this contract will have and see if WLS is covered or an exclusion.

If you find out that the new coverage has weight loss surgery then the following link is the medical policy for Anthem and the policy is not a guarantee of payments or benefits and therefore subject to medical necessity if your contract does cover WLS

http://www.anthem.com/medicalpolicies/policies/mp_pw_a053317 .htm

Hope this helps if you have any further questions regarding this please let me know if I can be of any assistance