bc/bs of al

livinglife42
on 2/17/05 10:14 am - HOOVER, AL
i am doing my 6 months supervised diet with my pcp this is the only diet i have been on that is being documented prior to requesting surgery, other than my diabetic diet. i do have documention of morbidly obese from 2001 to 2005 and a few notes in my chart were my pcp stated i need to stick to my diabetic diet, see a dietition and lose some weight... i am 265 lbs/ 5'4 with several co-morbid conditions,what do you think my chances are getting approved the first time
ng
on 2/17/05 10:33 pm - Southwest, LA
Do you have a WLS surgery exclusion by the employer, if so, you will have to have it waived by employer. I was lucky, I was in the first year that BCBS had taken over insurance for my employer, and you know how it is when employers negotiated......."we don't want to a reduction in benefits etc--- " because employees would scream. The old insurance HAD WLS as acceptable........... so BCBS included it, but when May comes, they will probably NOT have it as included............ Some others here are having trouble getting BCBS to approve WLS, lots of policies are on a regular calendar year........... my situation is a bit different probably due to being a school system and we are self insured. You may be lucky with the policy term beginning and end also, depending on employer. It is one thing to check, and try to apply ahead of just in case they plan on making changes (either employer or insurance company). A lot of this depends on the actual insurance benefits picked by both of them when it was set up or negotiated each time.
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