Federal BCBS Q - HELP PLEASE !!

Ok - after Federal BCBS PPO swore up and down that the lap band absolutely was not covered and they would only pay for Gastric Bypass I have now found two people (one from 2003, and one from July 2005) that did get Federal BCBS to pay, despite their clear exclusion: The following are excluded from this plan: Services, drugs, or supplies for the treatment of obesity, weight reduction, or dietary control, except gastric bypass surgery or gastric stapling procedures; or Services not specifically listed as covered. I may use these two cases of people to appeal - I am looking for more also --- PLEASE HELP - Please email me if you have had federal BCBS PPO approve or pay for your lap band procedure. Please provide your name, your doctors name, the state you live in, your surgery date, and the hospital where you had surgery. If they are approving some people and not others and its a national plan I think I may have grounds for appeal !! PLEASE PLEASE HELP !!!!!!!!!!!!!!!!!!!!!!

i have to tell you something, email me.

Hi Arnie, I have been denied by BCBS PPO National as well. They say they will not pay for lap surgery it is too experimental. They will only cover open gastric bypass. I could not believe this! I told the CSR at BCBS how could this be experimental, In Baltimore City alone, Sinai, Union Memorial, Johns Hopkins and University of Maryland all offer Lap bypass. I told her Dr. K has done between 450 & 500 of these surgeries with very very low complication rates, how can they say this procedure is still experimental? I am looking for information to file in my appeal letter. My daughter works for an attorney and will help with letter. Good Luck to you and let me know how you make out.