Newbie--Florida BC/BS

Hello! I am new to the site and exploring wieght loss surgery. My sister had a WLS last year and it has been perfect for her and I really feel it would work for me.

I have BCBSFL Bluechoice for individuals under 65 nongroup

I asked for a benefit book which showed coverage, but when I called to confirm, they said they sent the wrong book and I am not covered:?  Has anyone had to deal with this BS???

I really need some help as I am not understanding how they can change or tell me "oh yeah, it's an exclusion" 

If anyone has had success with BCBSFL and WLS, please help!!!

Thanks in advance!!!

Hi there, have you seen a surgeon yet?  If you have picked one, they will submit the paperwork for you.  There are times that you can fight the exclusion or they might make you do the 6 month documented diet.  We didn't have any luck with United Health care but hopefully Blue Cross is different.  I think it also depends on what other issues you have, high blood pressure etc.  If you get denied try the "Main" board and there are people that can help you with sample letters for appeal.  Good Luck

Have you gone to an information seminar?  Most of the surgeons have an Insurance Coordinator that is very knowledgeable about coverage and does all the work for you.  I didn't have to go down the insurance path as my insurance doesn't cover bariatrics, so I knew I would be self-pay.

What type of surgery are you looking for?  Some insurances will pay for some procedures and not cover others.

Sorry I can't help with the WLS insurance stuff but I wanted to welcom you to the Florida forum

I have BC BS FL Blue choice and i was told WLS was excluded

I have BCBS of Florida but have a PPPO (not Bluechoice) 
My surgery was covered 100% (less any unmet out of pocket max for the year)

I agree with the previous poster about going to an information session.  It is worth it just to find out what your coverage is.  If you are close to Celebration, FL you may want to check out Dr. Kim.  I think he has a seminar every other Wednesday evening at the hospital and the insurance coordinator (Amanda) is there to help you.  She submitted my request and got my approval in less than 24 hours even though normally it may take 2-3 weeks.  They are very competent - the entire office - and a pleasure to work with.

I have BCBSFL and anything weightloss related is an exclusion in my plan.  The only thing they offer in terms of weightloss assistance is a discount to Jenny Craig and some YMCAs. 

BCBS of FL generally does not cover WLS unless your policy has a special add on that will cover it.  It is up to the company, etc that you are getting your coverage through.  For me my company had the added coverage so it was covered for me.  Best to work with your surgeons office too on this...

Jenn