For those of you with Blue Cross

I received an email from the NC Dept of Insurance that blue cross will be changing their criteria for WLS in August. They were unable to say what the changes would be, but I would assume they are going to make it more difficult or adopt Cigna's standard of requiring 6 months physician supervised weight loss. Just wanted to let you know!

Hi Jennifer, I am so glad I am already approved!!!!!!!!!!! Thanks for the info. Pat

I got the information from the North Carolina Department of Insurance. You may want to see if South Carolina has the same thing. Usually when an insurance changes critera it effects HMO and PPO alike. If SC is going to change as long as you get your authorization request into the insurance company before they change I wouldn't see an issue. Not sure if they "grandfather" people in that put in for the authorization before the change or not.

I had to call BCBS today for another reason and decided to ask about this. I have BCBS of Arkansas (PPO). To put another twist on it, they told me that the changes also depend on what your employer allows. Mine is the only one in that state that allows full coverage for WLS. Since my employer seems to be 'all for it', the changes won't affect myself and my co-workers as much as it would people in AR with a different employer who have BCBS. The rep explained that the changes she knows of will only affect documentation, not requirements...I did document my five-year history, though it wasn't required at that time.