Lap-Band Insurance Problems

I have just been denied pre-authorization for Lap-Band surgery by BC/BS of Wisconsin (PPO). I am preparing an appeal letter but I would like to know if there are other folks out there who were either approved or denied for Lap-Band by BC/BS of Wisconsin. Can you share your story with me? I'm just trying to decide whether it's worth it to fight or if I should start preparing to self-pay.

Astra: I had Blue Cross/Blue Shield last year and they did approve me, but not until after several road blocks. First of all, I had the RNY which was not considered experiemental, so that might be something you should consider in order to get them to pay for it. I also had a pysch eval, proof of medical necessisty and proof that I was attending support group meetings before surgery. I got 2 denial letters and finally after all the paperwork got there at the same time, they approved me. It took me over 3 months. I would strongly recommend the RNY. I had surgery in August and am down just over 70#'s now and still loosing. I know every Blue Cross Blue Shield policy is different and I wish you the best of luck getting them to approve you. If they don't and you can find the finanacial means to self pay it is definately worth it!!! Take care and feel to email me if you have any questions.

Vicky, Thanks for your kind post; it's definitely great to hear from folks within the state. I am committed to Lap-Band, however, and intend to keep pushing for that. I'll be sure to post to this board with an update of my progress with BC/BS of Wisconsin. -Astra