Which Insurance more WLS Friendly---- Blue Cross/Blue Shield or United Health Care?

Through my employer, I have United Health Care Heritage Select POS and my wife has just started a new job that has Blue Cross/Blue Shield of Tennessee Partnership PPO.

She is enrolling now, and can add me on to her plan effective October 1st if necessary.

My initial consultation with WLS Doctor/Seminar is also scheduled for  October 1st.

I would appreciate comments from those who have had WLS using coverage by either of these Insurance Carriers, so that I can make a decision as to which would be more willing to cover procedure.  I am currently leaning towards sleeve, but still considering options.

I would call the bcbs and find out the requirements. I have heard good things about their timeframe for getting approvals back, but everyone's policy can be different.

I have BCBS, it required 1 month of dr visits and a nutrition class.  Bmi of 40+ and no comorbidities. Or 35+ with at least 2 comorbidities.  

I would still check to make sure if things change or are different, my Insurance is Anthem BCBS. 

It depends on which specific policy you have.  You'd need to check with your insurance company to find out about the specific policies available to you.

You'll want to read the policies yourself and make sure there aren't exclusions written into them.  Both do cover wls, however the employer can save a lot on premiums if they write in exclusions to the policy.  WLS is one of those exclusions.

You will have to look at the individual policies... I have CBS of IL PPO, and I had no waiting period, but needed to have Psych, Nut and consult before approval. I was approved within a week. They pay 80%. 

good luck

BC/BS FED paid for both for me. Lap band in 2007 and revision to RNY in 2011. Both times answered in 1-2 weeks. Wish I had done RNY first time. Hit goal in about 6-8months. I'm at 127 and holding! Love my life..

As others have said, it isn't a matter of which insurance company, but rather of the specific policies that your company has WITH those companies.  Just because my Blue Cross covers WLS doesn't mean that yours will cover it at all or that the dollar amount they cover will be the same for you as it is for me (some policies cover it at 100% while others cover only 80% and some even onto cover 50% of the cost).

You need to get copies of the coverage bulletins for each policy (the insurance company can provide one or your HR folks can get you one) to see whether they cover WLS at all, what the approval requirements are, and which type(s) of WLS they will cover.  My current BC/BS policy only covers RNY, for example.

Lora

I have Blue Cross of Illinois.   They were great.   My policy simply required I met NIH requirements, which my bariatric surgeon would have required anyway.

I have BCBS of Alabama and it was a fairly simple process, was approved on our first attempt.  I am not sure if this is true for all offices, but I would suspect it is true for most.  Ask your surgeons office.  Mine had a girl who did nothing but work with the insurance companies.  They maybe be able to tell you better the prerequisites required etc.