Blue Cross Blue Shield State Health Plan

Hi just wondering if anyone on here has ever gotten the SC BC/BS State Health Plan to pay for their WLS after BC/BS State Health plan changed to WLS exclusion?

Don't know if it would be even worth my time to apply and let them deny, and then appeal. 

Someone said that if my policy had a WLS exclusion in it, that the insurance company would not pay, no matter what the Dr's reason's were that I needed the surgeryand, if I appealed they would just continue to deny.  

Please let me know what you all think.
Lavanda

 

Hi....I have state employees insurance also and I don't think that they will pay for anything weight loss related. I had another insurance when I had surgery and when I got the state insurance and went to my doctor they said it wasn't even a need to submit the claim because they know from experience that they will not even pay for a doctor's visit. That really sucks..... But there's no harm in trying if you have a doctor that is willing to submit.

There was someone at the seminar that I went to who had State Health Plan BCBS and he said that he was told the same thing.  They would not pay no matter what, no way, no how, period.  So he is going to pursue it as self pay.    My husband's company has BCBS but it is BCBS of Alabama and not SC thank goodness.  There were no exclusions on his policy, so they will pay, if I meet the medical criteria.  I have to do a 6 month doctor supervised diet first.