BCBS state group

LP31FL08
on 3/2/11 2:06 am
Hi all I am new to OH and have a question. I have my consultation with the doctor tomorrow about having WLS . I currently have BCBS and have been told in the past that they do not cover it, I have called BS and State group to verify. Well my boss who has the same BSBS as I do just got approved for RNY his surgery is in 6 wks. with the same Doctor that I have my appt. with tomorrow.  Him and I both a about the same problems, but I also have bad knees, sleep apnea, and a BMI of 49.
I am just wondering has anyone else had success with BCBS on gettting approved?
 My fingers are crossed, prayers needed for my approval reaching out for much NEEDED prayers! thanks
faerey
on 3/2/11 2:55 am - Zachary, LA
I'll be swinging critters for you! I don't think you should have any problems being approved depending on which surgery you are interested in. They seem to approve some easier than others. Let us know how it goes!
 "Imperfection is beauty, madness is genius and it's better to be absolutely ridiculous than absolutely boring."     Marilyn Monroe    HW: 232   SW: 226   CW: 150.8                                                                                           
              
Seana 
louisianagirl09
on 3/16/11 5:47 am - Lafayette, LA
BCBS of Louisiana has an exclusion for bariatric surgery. Unless you have a self-funded plan there is no coverage.  The state group has no coverage so not sure how your boss got approved.
pamm132
on 4/13/11 1:50 pm
I am with BCBS for state employees also.  I received my call today & was told about the exclusion.  I don't know how anyone would be covered.  My understanding is there are no exceptions with this exclusion.  I am considering self pay.  Good luck to you.
    
Puppylovemommy
on 4/25/11 9:59 am - LA
My husband's policy is also BCBS of LA (self-insured by company) and there is an exclusion.  I just don't have the time to wait anymore. We are taking out a loan and then having the house refinanced to pay for the surgery.
            
BeautifulCajun
on 11/14/11 10:43 pm - Evangeline , LA
I was wondering if you have updated. I have heard about some getting it approved and some not. It's all in who you talk to and which codes they put. Its sad. Same with every insurance.
LP31FL08
on 11/14/11 11:15 pm
No I was not approved. Well actually when I went to the Doctor the nurse never called me back, I called them and she told me that it was an exclusion on my insurance that it would not be covered. I asked if she turned in the paperwork to the insurance and she said no, with an exclusion we don't send in any paperwork. I was very upset at least they could have sent it in and got me that denial letter so I could fight something, 
I have had several people tell me that it was excluded on their insurance, but the doctor wrote a letter of necessity and it worked and they were approved. Still trying to find a way.
BeautifulCajun
on 11/15/11 3:30 am - Evangeline , LA
DONT GIVE UP!!!! You are your own ADVOCATE!!! That is what you will have to do!!!
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