QUESTION about INSURANCE!!
(deactivated member)
on 6/9/04 12:32 am - Idaho Falls, ID
on 6/9/04 12:32 am - Idaho Falls, ID
My BCBS insurance policy states "weight loss treatment and reversal of previous weight loss surgical procedures is not a benefit". Is this considered a written exclusion? Is this worth appealing or am I just wasting my time?
April,
I know people who have BCBS that have had the surgery. It sounds as if the company you work for was the one that put the exclusion in there. You can write a letter to the people who wrote the policy (maybe your union) and ask them to change their policy and add this as a benefit. In my situation, Regence BCBS of Oregon told me that they cover this surgery;however, my company chose to exclude this surgery. So I now have to write a letter to Nelson Trust. I believe that they are over the union at my husband's company.
Don't give up!!!! There is always a way...sometimes we just have to wait a little while.
Karen Lemley
have you already been denied?
The exclusion does not state that they exclude surgical treatment for morbid obesity, just weight loss treatment. The fact that they address the reversal of such surgical procedures and yet not the procedure itself leads me to believe that they are not excluding it. At least it looks like you have a good fight.