Hello, I'm new here. Found this place after searching for a forum about gastric bypass surgery. I'm glad there's one! I have a couple of questions. Right now I have BlueCross BlueShield of Texas PPO. I went to a website where they check the plans and doctors in my area. They told me the current plan I'm on doesn't cover any kind of gastric bypass surgery. I called BCBS to find out what plan I can get on that would cover it. They told me there's no plan in texas at all that would cover any part of gastric bypass surgery. I've read on here and other places that some people did get covered by BCBS. My question is, does bcbs really not cover it or is it something they don't want to cover and they just say that so you don't pursue it more? If they don't, is there a healthcare provider that does? I'd gladly switch to have it covered, seeing as I don't have $22,000 to fork up before the surgery. I'm paying for the insurance myself. Thank you ahead of time for any responses.

 I know that Aetna covers it,,,or at least they covered mine over 4 1/2 yrs. ago.    You may want to call some major insurance companies and ask if they cover WLS.    That way you know it will be covered by insurance.    Good luck and welcome to the Texas Message Board ( TMB ).


Hugs and blessings ~~~ Vivian

No INDIVIDUAL plan you can buy in Texas - not one - covers WLS. Trust me, I looked. The people who DO have coverage have it through their employer that specifically contracted WLS to be included in their GROUP plan.

Hope that clears things up.

I have BCBS of TX and they do cover the surgery.  I am not sure if there are plans that exclude it.  The link I was given in the past that I just checked gives you their guidelines, it is www.bcbstx.com/medpolicy.  After you agree to the terms, you can search of morbid obesity and it will give you an option for Bariatric Surgery.  Please don't quote be on this, and I hope this helps.

Thank you all for your responses. Seems I'm out of luck for now then. cjrust, I'll look into that, thanks!

Just to put this out there, you may not have $22k, but you can go to mexico for about $14k, if that helps any. It took me 3 years to raise the funds, but I'm going soon!

 I was thinking about that. I live in el paso, which is spitting distance from mexico. But I don't know how good the doctors are over there. It's still a lot of money but it is cheaper than here. good luck!

I have bcbs ppo and they covered mine, but that was 5 years ago.

You have to remember Insurance companies are in business to make money. Many insurance companies will tell you that they do not cover bariatric surgery. However, many have a nice little unknown clause that states in you are diagnosed as being morbid obese and follow a specific criteria then the surgery is covered BMI >40 and co-morbidiities. I would go over your policy with a fine tooth comb. I am insured through my employer and have United Healthcare manage the insurance because we are a sellf-insured company. My policy had a unknown clause in you are diagnosed as being morbid obese it is covered. What was hard was finding a surgeon and facility that would work with my insurance to keep my out of pocket down. Do not give up on your quest for bariatric surgery no matter what procedure you want to have done.