Need help from Louisians

Hi everybody hope that you could help me.I am going to try and fight BC/BS.Could everyone that has BC/BS of Louisiana.E-mail me and let me know if you were aproved or denied for the WLS.Thank you. Sarah

bc/bs told me that they would not pay for me to have the surgery for any reason. I was paying $270 per month for over 5 years and had never used the insurance for anything. I asked bc/bs what they would cover and they essentially told me that I was screwed. I dropped the insurance immediately. This just goes to show you that you live in a state with several ex insurance commisioners that are now currently visitors in federal facilities.

Hi Sara, my first time posting a note. Well I have BC/BS through my husbands employer and guess what, they have a written exclusion regarding any treatment for "Obesity". I've called, and the insurance department from the doctors office called and they said no way, no how. Since it's an exclusion, doesn't matter if it's medically necessary. I think all insurance should pay for this. Hope you win your fight!!! Tina

I have BC/BS of Louisiana too and like you, there was no way to fight back. They have a written exclusion. I even had Human Resources check into it for me and they said that BC/BS has NEVER authorized this type of surgery. No matter what! They don't care of you are on your death bed! Before my insurance denied me, I was already in the process of doing research on the Net and came across obesityhelp.com. That is where I found myself looking at other options I have read on obesity.com South Of The Border. Reading other personal stories on Dr. Aguirre forum, I have found myself wanting to learn as much as I can about Ensenada, Mexico Baja California. So back in November 2003 I went to Dr. Aguirre website and requested more information. He gives you his mobil number. And after surgery, if you need something for pain, The "Pain Doctor" is Dr. Gomez who is famous for his "shot of tequila" (right before going into surgery) (Valumn) will even come to your hotel if you should need anything for pain. Now what Dr. in the US will do that?!! http://www.derivaciongastrica.com/english/ Anyway, The Doctor wrote me back the very next day: Hello Marlene Our procedure is the Open Gastric `Bypass. I have to see you a day before and in this day we do the lab work.You have to stay in the hospital for two days and could leave our town on the 5th day after surgery.The total cost is $8,500 and I have open in March 2004. There is a transportation service that will bring you to Ensenada and back to San Diego Airport after the surgery. It cost $300 round trip. I have after March 15th. I am going to give you March 16th. If you agree, please let me know. Bye Dr Aguirre Now I am doing the HAPPY DANCE!! I've got 25 more days and I will be on my way to Mexico! BC/BS can just kiss it!

I know exactly how you feel! My husband used to have BC/BS through his employer and it had an exclusion too. I called everyone I could think of to see if there was any way around it.....there wasn't. Then my husband switched jobs and we had to get self insured. I called all around and found that Ochsner covers WLS if it is medically necessary. I called them myself and they said most plans covered it, so I just made sure my agent knew I wanted it covered. They were easy to deal with because they don't deny you because of your existing weight like alot of insurers do when you are self insured. Once I got my policy number I called and they said it is covered as long as it is medically necessary. I havn't done it yet bc I am in the middle of buying a new house and moving, but my plan is only $150/month. They had one that was a little more that had copays but I chose the $500 deductible since i knew I would be meeting that. So if all else fails you could get Ochsner for just you so you can go through them for the surgery. Oh...and there is NO waiting period! Hope this helps.