BCBS & DS

Hello,

I just called BCBSIL, and the procedure code I gave them for DS is not COVERED!

How is that possible!!!! They then told me I might want to ask them for another procdure code!

I NEED YOUR THOUGHTS!

I am soooooooooooooooo hurt right now!

Datrace,

I am quickly learning that the information you receive over the phone from your insurance company can be quite different from the "reality" of what your policy does and does not cover.  Until you see something in writing, do not believe it.

You need to read your policy to know if the DS is covered.  Your employer can provide this for you, or BCBS may send you the relevant pages. 

It may be that the DS is covered only in special situations, but that it is not covered in general.  For example, my policy (BCBS of MN) states that the DS "may" be considered necessary for individuals who have a bmi greater than 50 AND significant co-morbidities.  I want to make sure to state here that EVERY policy is different, even policies within the same state - so you need to see your policy to know for sure.

HTH,

Naomi

Hi Datrace -  See my response to your investigational DS post about insurance, but I agree you should ask your employer or HR dept for a copy of your policy. Sometimes they just say "weight loss surgery" and don't specify the DS, but as it is a type of WLS, it would be covered under that phrase.  Hang in there!