BCBS of AZ

Hi all! I was wondering if anyone could give me some info on Blue Cross/Blue Shield of AZ? I have been searching through their website and found that there is a new fee of 1000.00 for the gastric bypass surgery starting this year but I was looking for any pre qualifying things they are needing. (Doctor visits, nutritionist, co-morbidities, written diet, written exercise plan)? Any info would be greatly appreciated! Also does anyone out there find that the insurance companies, overall are starting to approve WLS more frequently or is the surgery getting harder to be approved for? Just thought I would throw that in there. Thank you all for such wonderful support!

Hi Karen: I do not know anything about Blue Cross/Blue Shield. But on your second question I have Humana Choice Care Plus. I work at a very large company here in Phoenix and so far none of us have had any problems getting approved. About 20-30 people that I know so far. My approval took 4 days after I had all my paperwork in. For the year 2007 it is still being approved as I have 2 friends who have just started the process.

As far as I know there are very few insurance companies left that will cover WLS. It is being considered a fad surgery or cosmetic, more like the latest diet craze then a real medical need (To the insurance companies). At least that was the spin on it that I have heard from the insurance reps as a reason for insurance companies dropping coverage.

From my experience, BCBS of Arizona is very difficult to get approved with. A friend of mine has BCBS of AZ and she had to have 6 months of doctor supervised weight loss with detailed written documentation, co-morbidities... a high BMI is not enough. She is still dealing with the insurance company. She was denied and now doing her 6 months of diet. She is waiting for open enrollment to switch to another insurance company. I think each insurance company are so different and it really depends on the person. I have talked to people that have gotten approved in a heartbeat with co-morbidities and those that have a high enough BMI and a history of obesity (myself) to those that you would think would get approved and have been denied and fight a real long battle with the insurance companies. Unfortunately they are pretty unpredictable. What makes a difference is having all your ducks in a row... when I called my insurance company they required documentation of previous attempts, letter of medical necessity... so I got everything I could find. Weigh****chers records, Jenny Craig, Gym memberships. When they went to submit my approval they wanted 6 months of doctor supervised weight loss... so they change their requirements based on the person. The whole insurance thing is stressful sometimes.