Severely Disappointed

Well, after finally securing a job that actually offered health insurance, waiting the 6 mths to be eligible...I just got the policy today. Tucked neatly inside my policy from BCBS of Florida was an exclusion that says: "Weight Control Services including any service to lose, gain, or maintain weight regardless of the reason for the service or whether the service is part of a treatment plan for a Condition. This exclusion includes, but is not limited to weight control/loss programs; appetite suppressants and other medications; dietary regimens; food or food supplements; exercise programs; exercise or other equipment; gastric or stomach bypass or stapling, intestinal bypass, gastric balloons, jaw wiring, jejunal bypass, gastric shunts, and procedures designed to restrict the Covered Person's ability to assimilate food." After 18 years of dieting, now what? This was my goal for the year and I have no idea how to proceed.

APEAL APEAL APEAL!!! Bulldog Lady

Appeal! Give them hell. If PCP says it is medically necessary they will have to cover WLS.. I think??????? Marla PS what I plan to do should I not be approved.!!!

Unfortuntely no, just because it's medically necessary doesn't mean an insurance company is going to pay for it. With BCBS PPO, I was approved the first time in about 4 weeks. However, I know that they are not covering the surgery AT ALL effective January 2005. We all need to flood our legislators and tell them a) get out of bed with the insurance companies and b) MAKE ins companies pay for this life saving CURE! Good luck! Barbie 1-21-04 281/232/150ish

First of all start seeing a doctor and get a diet, weigh in once a month every month. Also you can buy your own policy. Do some research around here. See who is covering it and not. They are losing billions of dollars by this surgery. Because it is working wonders for lots of folks. and their lack of medical neccessity is lowering...so they don't really want to "fix us" lol. I can tell you GHI is still paying for it, I will have my surgery tomorrow. I can also tell you they will want a six month letter of doctor monitored diet and weigh ins. Good luck and God bless, Rj

I also have BC/BS of Florida. The note I received was the same except it has the date of January 1st, 2005 as the first date this exclusion goes into effect. That is one reason I chose to go forward now. I don't see how they can make such a drastic exclusion when obesity is an epidemic but then again it seems our country is founded on insurance companies now!! Let me know how you make out.

I have BCBS of FL too and was just approved. I believe they are approving it until 1/1/05 so HURRY!!!

My husband has the same insurance and his takes effect January 1, 2005. So you might want to double check the effective date. You might have time to do it still. Good Luck Lise

Thank you everyone for the response...because of you I took a closer look (and read the fine print) and you are right...it does say it goes in effect in January! Guess I better HURRY! Thank you Thank you Thank you *big hugs to all*

Hi Angel, I know that now no matter what state your blue cross is in, if you go to another state the claims are processed by that state's blue cross.... So I think, (I could be wrong) that if you go to another state (like California) that their blue cross covers the surgery, that yours will be covered too!! I'm sure about the first part that whatever state you are in, they process the claims, I'm just not sure about the coverage part. Good Luck