NEED HELP ON INFO ON FLORIDA BLUE CROSS AND SHEILD

I'M 44 DAYS POST AND HAVE LOST 50LBS, BUT I HAVE A GOOD FRIEND WHO LIVES IN YOUR STATE, AND HAS BEEN TOLD THAT BC&S DOES NOT SUPPORT WEIGHTLOSS SURGERY, HAS ANYONE WORKED W/ BC&S NEED HELP!

I have BC/BS Blue Choice (PPO) and didn't have too much trouble getting approved. But the policy does have a part that says they will cover WLS if medically necessary. Some policies don't have that or actually say they won't cover it for any reason! The policy needs to be read from cover to cover to see. I did that before even considering the surgery. Does your friend have any co-morbidities?? That would help for an appeal, if needed. My policy routinely rejects the first try and was appealed. I got it on the appeal, so it does work! Tell your friend to hang in there and fight for what is needed for better health!!

I am 3 1/2 weeks post-op and have BlueCross Blue Choice PPO. My brochure stated WLS was covered if over 100 lbs overweight, have hypertension or other weight related medical problems and BCBS authorizes it. I was ok'd in 2 weeks. The only thing they requested after doctor requested tests was a pulmonary clearance. Have your friend check her brochure under "what is not covered" and see what they say. It should say either they will absolutely NOT cover it or will have something like mine. Employers have different contracts with BlueCross so every plan is different.

I also have BC/BS PPO. Mine says must be medically neccessary. They have been approving many folks. Even my insurance team members have had WLS (3 of the 5) so they are very helpful. I first attempted approval for the lap-band. They will not approve. So went with RNY. I am in Tampa area and using Dr Murr at TGH. He is excellent. Ten years experence with WLS. Staff is excellent!