Does anyone have BCBS of GA Blue Choice POS

Son and Daughter in law have this kind of insurance. Both are extremely overweight and are interested in finding out if they can get lapband on their insurance. Since it is closed this weekend thought I would ask here for them. Thanks  Phyllis

My husband's company offers both the BCBS of GA HMO and the POS and neither will pay for the surgery.  It excludes anything related to weight loss.  I have found that most BCBS of GA don't pay for the surgery or anything weight loss related. Best thing is to look in your certificate booklet or call them directly.  Lucky for me my new job covered it with UHC.  Or I wouldn't have had the surgery.  Best of luck!

thanks for answering

Hey Phyllis! BCBS of GA doesn't specifically exclude it, they paid for mine! It is all up to the employer group. From what I understand there is a WLS rider that the group can purchase. If the group has decided not to purchase the rider, thats when it is not covered.  I'd have them check their benefit booklet, call customer service and also ask the employer! Hope it works out for them! The Other Phyllis J  

Wow should have asked you first. Didnt realize you had bcbs of georgia. I have no idea what blue choice POS is and i figured they will have to contact the HR of his work to find out because I knew there were riders but hoping that most that answered would be yes they cover it.

POS stands for Point of Service, it is very similar to HMO but I THINK the difference is that with POS your medical care does not have to be funneled through a PCP.  

My employer offered two choices at open enrollment time, the only time we can make changes to our insurance coverage.  The choices were BC/BS HMO or Cigna Open Access Plus.  Before making my selection, I investigated both policies and the BCBS HMO had the exclusion policy, the Cigna Open Access Plus had the rider to allow coverage for gastric bypass.  So obviously, I chose Cigna.

It's not the insurance company that determines this coverage, it is the employer who purchases the policy and if they chose to include or exclude.  My coverage does not allow Lap-Band, but did allow RNY. I wish your son and daughter in law good luck.   Alot of insurance companies are requiring a 6-month supervised diet, so if they do not have that yet, they should start that process ASAP with their PCP.   I've got 2 more weeks to go to complete my 6 months and then I can finally submit my paperwork for approval. 

Hello, I have BCBS Choice with POS.  My rny was covered in 12/03 but it does depend on what coverage thier employer has.  The following year after my surgery, our policy changed and it no longer covered any bariatirc services.  They do still continue to pay for my yearly checkup with my surgeon. The POS part basically lets you see any doctor without a referral.  You do have to pay a deductible and then a higher percentage of the fees. 

Marie

 

Hey there! I have the BCBS POS too, through my husband's job at the local fire department. His policy also denies the coverage for the surgery. When I cantacted BCBS my self, they said that they BCBS don't exclude the surgery, that my husband's employer opted not to have the rider that would be needed to pay for it. I am still in the appeals process with his department now, but it still looks like I am going to have to self pay or get a different policy all together. I hope that all goes well with your family, it's not an easy road no matter how they go about it. But it's worth it for their health! Tell them not to give up the first time that they are told "no".  Good Luck! Michelle

Hello Everyone, I have the BCBS of Ga  POS (Point of Service). The company I work for is self ensured and uses the bcbs network. My company does not exclude wls but will only pay 50/50 .