WLS Excluded?

My question is:  how common is it for an employer to take WLS out of coverage?  Does anyone have experience with Blue Cross POS as to how common it is for their policies to exclude WLS? Why would it be covered one year and excluded the next? Thanks for your help.

{ krystin }

My husband's employer excluded WLS and after enough employees requests it was put in this past June. I started my WLS program before our insurance covered it and about 2 months into it, they decided to cover the surgery. So don't give up hope, with more and more studies showing the positives for patients and their employers some places will start covering it.

Does anyone have experience with Blue Cross POS as to how common it is for their policies to exclude WLS?
It has nothing to do with Blue Cross' policies. The employer is who choses whether or not to include the rider for WLS.

Why would it be covered one year and excluded the next?
Excluding WLS lowers insurance costs for everyone. If the cost of coverage for one thing has increased, an employer might make additional exclusions (like for WLS) to make up the difference in costs to avoid increasing their employees' rates.

I have BCBS of Fl, and my employer has a fully-insured policy - BCBS of Fl stopped paying for WLS in January of 2005.  It's an exclusion on the policy, and I'm trying to prove medical neccessity.  Everything I read tells me not to get discouraged, and I'm trying not to, but I feel your pain and frustration.  Just hang in there, and see if you can get a letter of medical necessity from your PCP.