Help in KC...

I am 100 pds overweight. I have BCBS of KC PPO. In reading my certificate of coverage all weight loss related surgeries are excluded. That said, I am wondering how so many people were able to get it covered. Maybe you could share your secrets on how to get it covered. Also, I am interested in the LAP-BAND procedure and am looking for a surgeon in the KC area that anyone has had a positive experience with. Thanks for the help. Lissa

I am sorry to say I didn't have any luck with BCBS of KC PPO. But I have a wonderful surgeon . Dr. Kaniewski of the MISH in Lenexa. I live 50 minutes away from this office but I would drive hours for this hospital and staff. 913-322-7401. I just started a social support group monthly with them and we had a great meeting last Saturday. Planning on a clothing exchange. If you have any other questions or need to talk e-mail me directly and we can share phone numbers and talk. Wish you the best of luck. Joy

Lissa, I too had BCBS and it was excluded, totally, no chance of reversing the decision. I did have secondary insurance that paid all but $13.00 (thirteen dollars!!!). So I feel very fortunate. I wish I had some advise, but there was no appeal that worked for BCBS. So Sorry.

Uh oh, you all are scarring me. I have BCBS of KC - Federal Employees Plan. But I have checked the Service Benefit Book and it says Covered - Gastric bypass surgery - if over 100 pounds or 100% over normal weight. However, I have not had my consult appointment yet so they have not submitted the request. Was any of you're the Federal Employees Plan?

HI, I have BCBS and they covered everything. I got a statement today and total costs were around 23,000. As long as I had a BMI rating me as morbidly obeese and had to pass a phych. eval and talk to a nutritionist. I was really lucky. If my insurance wouldn't of covered it I wouldn't of been able to have lap-band surgery. Good luck! Lynette

There are a lot of different BCBS policies and each one is probaly different in a lot of respects. Call the insurance cordinator for the one you have to see if it is covered. Jan

My plan is through a private employer so you may be lucky. I think each employer can pick what plan they want to to offer their employees and ours is awful in a lot of ways not just this. Good luck to you!! Lissa

Hi lissa, it looks like this post is from a while a ago?? I also have bcbs of kc,mo and mine has an exclusion but im still going to see if I can fight it? I havent heard good things about getting them to say yes. I am in the begining stages.I am however going to go to lenexa this Saturday to a exclusive WLS seminar/hospital in lenexa,ks to see if they can help me?? Let me know what has happend for you. Thanks kim e-mail [email protected]