BSBC California

Has anyone had any difficulty with BSBC of CA? My husband just started a new job and has this insurance. I was thinking of having either the Gastric bypass or the Lap band. My questions are does this insurance cover these procedures? What do they require? Has anyone had problems getting approved through them? Thank you in advance!

Although I do not have this insurance, the answer seems to be the same for all of them.  You will need to call your insurance and find out if your co.plan covers WLS, then, if they do what their specific requirements are.  This is where there seems to be the most hang ups and where the insurance companies seem to try and "get" you.   Each case is diff., and hopefully yours (if you decide to go through with it) will be smooth as many posters here have.   However.....I would still be prepared to put your sneakers on and start jumping through hoops! Good Luck

Hi Filipina, I have BCBS of CA the PPO plan.  Under this plan lap band and rny is covered if you have a BMI of 40 or greater.  In my case my bmi was 38 so I had to provide a copy of my medical records over the last five years, undergo a psyche exam , have my primary dr. write a letter recommending that surgery was in my best interest due to my family history of breast cancer (maternal & paternal), strokes and heart attacks plus include copies of my Jenny Craig and Weigh****chers receipts. It took a little while (4 months) but at least I did not have to do the 6 month doctor monitor weight loss like other insurance carriers require. I opted for the lapband and had surgery Sept. 5 of this year. You can go to the BCBS site and it contains their standards for lapband/rny surgery that you need to comply with. www.bluecrossca.com Good luck with your journey!

My husband and I have BCBS CA (HMO). Starting this yr (2007) they require a 6 month supervised diet. We have just finished this process. The good thing is BCBS paid for it, minus co-pays of course. The weight managment center completed the necessary referrals for psych, blood work etc... and now that we are done the paperwork should be submitted for approval after Thanksgiving. I have a BMI of 43 while my DH is 38 with co-morbidities and we both had to do the 6 months. Keeping our fingers crossed.  Good Luck, Diana