Insurance wording

kimberlygpena
on 10/19/12 7:27 am - Angleton, TX

RNY on 09/24/13

I have BCBS of TX PPO I have been reading my Benefits book and it has this listed for wieght loss:

Any servicesAny services or supplies provided for reduction of obesity or weight, including surgical
procedures,
even if the Participant has other health conditions which might be helped by a reduction of obesity or
weight. or supplies provided for reduction of obesity or weight, including surgical procedures,
even if the Participant has other health conditions which might be helped by a reduction of obesity or
weight.

But it also states exculsions:

Any services or supplies which are not Medically Necessary and essential to the diagnosis or direct care
and treatment of a sickness, injury, condition, disease, or bodily malfunction

If the DR states this medically necesasry do you think it may cover weight loss surgery.

Any comments welcomed.

Thanks

noftessa0401
on 10/25/12 7:34 am - San Diego, CA

RNY on 12/27/12

I think what you wrote was incomplete. Is the top part under "services and supplies that ARE covered"? If so, then it sounds like they might cover it. But I don't have enough of your policy language to make that layman judgment.

HW: 274 | SW: 232 | CW: 137 | Goal: 145 (ticker includes a 42 pound loss pre-op) | Height: 5'4"

M1: -24 (205) | M2: -14 (191) | M3: -11 (180) | M4: -7 (173) | M5: -7 (166) | M6: -8 (158) | M7: -11 (147) | M8: -2 (145) | M9: -3 (142) | M10: -2 (140) | M11: -4 (136) | M12: -2 (134) | M13: -0 (134) | M14: -3 (131) | M15: +4 (135) | M16: +2 (137)

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Insurance wording