Insurance Information

I'm having the hardest time with BCBS BlueChoice Insurance.  I know the policy I have has a weight loss exclusion so I know that I won't get approved through this insurance.  The company I work for will be switching to Anthem Insurance after the first of the year.  I have found this link on their website which suggests that wls is covered. http://www.anthem.com/medicalpolicies/noapplication/f4/s10/t 2/pw_034084.pdf I called our corporate office and talked with the guy in the benefits department and he told me to contact Anthem.  I called BCBS to see if they could give me information regarding if the company I worked for has opted to included this in their plan and I was told that they couldn't give me any information regarding my policy because it's not in effect til the first of the year.  They suggested I talk to the HR rep b/c they would have the information regarding what our exactly our company selected for coverage and if there would be any exclusions. I am so freakin frustrated it's driving me bonkers.  I'm mainly upset because my sister's insurance says outright that it will cover the surgery (she works for the state of missouri) and here I am desperately wanting the surgery and it seems like I hit a brick wall every step I turn.  I have a lot more comorbities than my sister and I'm finding it hard to be happy for her because my case seems hopeless.   I guess I should quit venting and get on with my question.  My question is can I get private insurace and if I did get private insurance would they cover the surgery?  I've thought about getting Aetna or whatever.  Also what do you guys make of the link I posted?  I would appreciate any advice.  Thanks. Leslie

Hi! First of all, I agree that the link suggests/ states the surgery would be covered, however- is this link a link directly connected with your companies specific insurance policy or just a general link on the anthem website? It could still vary, of course, depending on what your employer has elected to cover. I called my husband's corp. benefits and they were able to tell me exactly what the policy documents said about WLS. I think you should make that call again, to your companies corp. dept. and tell them you need to know what the policy documents state regarding weight loss surgery including any exclusions and any requirements that may be listed. You may have to speak to someone other than the first person who told you to call anthem. If that doesn't work, I also called the division for our BCBS that we will have next year (in Jan 07) and the rep was able to review the new policy for 07 and tell me what it said. They should be able to do the same for you, I think it just depends on the rep you speak with and is determined by how much they are willing to help you. It took me a couple of calls to get that information. Good Luck. Jenifer

I currently have Anthem and the company my husband works for excludes the wls portion. I did find out that in 2007 they will NOT exclude it anymore. Anthem seems to be moderatly easy to get approved by, so just ask your coordinator if they opted to exclude. If so, there is nothing to do except obtain private insurance. However, after looking into that option for the last 2 years, I have found that it is either excluded or you must wait 12 months. The tough part will be getting accepted by the insurance company with a bmi that would qualify you for the surgery in the first place. Not to be a downer, but I would keep my fingers crossed that your company will not exclude it. My insurance changed for the better so there is hope for you too!