Oregon Teamsters BC/BS

Has anyone had this insurance cover anything to do with WLS? Will it cover labs? Does anyone know ANYTHING about this insurance? Any insight appreciated Jen

Jennifer - is this Regence BC/BS for public employees?  I'm not in the union, but I have the same insurance as my classified staff, and they are part of the SEIU/Teamsters.  If that is what you have, these are the requirements:

1. BMI > 35mg/k² with a diagnosis of diabetes; or BMI 40mg/k² with any co-morbid condition; or BMI > 50mg/k² with or without co-morbid conditions.
2. A pre-surgical work-up is completed that includes all of the following:

   • dietary counseling and education;
   • medical evaluation;
   • psychological evaluation.

3. Weight loss of >5% over the 6 months prior to surgery.

I guess we are part of the bargaining unit called PEBB -- is that what you are in?  If not, Google BCBS of Oregon and they have most of their member info on line. Linda

Linda, Thanks for getting back to me so fast. In truth, I'm not sure what I have. They have yet to send me insurance cards and information to me. All I know is it's Oregon Teamsters/ BCBS . The company is Rockford Corp, which isn't union itself, but it's employees are? I don't know how it works, or I'd probably know what insurance it is for sure. Do you know? Jen

No - sorry , I don't.  Can you call your HR office and ask for a benefits booklet or ask if they have a link to the benefits on line? Linda

Rockford doesn't have an HR department. One of the drawbacks of being a construction company that grows too fast, I guess. But... They are considering hiring an HR person sometime this year... HOPEFULLY ME! LOL

I just checked. It is Oregon Teamsters Employer's Trust. local 223.  Anyone have this insurance? Can you tell me about it???

A great way to check for insurance benefits and weight loss surgery is to call the number on the back of your insurance card and ask them about your benefits.  The CPT code for gastric bypass is 43644 and the lap band is 43770.  Make sure that you document who you spoke with and what they said. The Best To You All, Robin

Thanks Robin. I have already had the bypass... I am just wanting to know if they'll cover my post op stuff like labs, or other surgeries if they are needed. I spoke with a rep today and she said it depends on the criteria and if I met it .. I went to Mexico and had a lower than "required" BMI for the US. If I have to, I'll just get my doc to document that I weighed more maybe. He already said he'd do what he could to help me out.

Jennifer,  Maybe I am not understanding your post but If your physician is willing to falsify your records to say you weighed more than you did,  he could possibly lose his license.  I would be amazed that a physician would do that.  Consider it insurance fraud for you and your physcian.   Julia

The only thing he would change would not be false. It would be my "beginning" weight. I had already lost a bunch of weight before approaching him about weightloss surgery. I already had the comorbidites documented medically. I believe the only thing holding me back would be my BMI, which was close to 40 when this started and I weighed 275+. I had already been dieting and wiped carbs out for over a month before seeing him and weighing 260. I don't think this is fraud. I wouldn't want to get in trouble and I doubt he would risk his license. Thanks for bringing this up, though. Jen