Has anyone heard this? Can they do this?! :mad:

As you may already know Blue Cross Blue Shield has decided to exclude the Gastric Bypass Surgery on all there policies starting January 1, 2 0 05. What you might not know is that they will not honor any approvals after January 1, 2005. This means that if you have not had the surgery prior to this date, you will no be able to have it or be considered as Self-pay. This decision will not only affect you, it will affect millions who are trying to overcome this life threatening disease. BCBS decision is base on purely prediction on future expenses that will incur due to the overwhelming demand for the surgery. The state Office of Insurance Regulation has approved the exclusion endorsement for large groups and small groups. As Dr. Forrester Vice President of Health Care Services & Chief Medical Director Of BCBS (HOI, Blue Options, Blue Choice) quoted on his final draft dated 1/22/04 " The popularity of Bariatric surgeries has grown dramatically in the wake of well-publicized operations among celebrities. The number of gastric bypass surgeries in the U.S. Has nearly doubled in the past year, and the demand is expected to grow exponentially." We are contacting all our BCBS patients because we feel that you play the biggest role in helping over turn this decision. Below is a list of Electronic Addresses so that you can contact the Medical Administration Staff and voice your opinion. Your prompt attention would be greatly appreciated from your peers and our Staff . BCBS Medical Administration Main Contact: [email protected] (VP health Care service and Chief Medical Office) [email protected] (VP Care & Network Management) [email protected] (Medical Director) [email protected] (Managing Medical Director)

I'm very surprised to hear this and immediately went to our Benefits Manager, who handles our BCBS insurance. She said she usually receive notifications of any major stops in coverage and has seen nothing thus far. She said she'd contact her reps at BCBS directly to see if this is true or not. What you read might be a case where the Office of Insurance Regulation has given approval to set up an exclusion, if an insurance company wants to. If that's the case, I imagine there will be companies that will exclude it from their coverage. Those who have any kind of major insurance (i.e. AmeriHealth, Aetna, Cigna, Etc.) needs to voice their thoughts now, because it won't be just Blue Cross that will apply that exclusion if they can. I'll let you know what she says - this would be BCBS for PA and NJ, including Keystone coverage. I imagine each division will set up it's own rules, unless BCBS decides to do an across the board exclusion. Scary and very sad thought... Denise 5/6/03 364/178 size 34 to size 10!

Very sad! The only reason I came across this is because I am shopping around for individual insurance and saw this......Thanks for the information.