bluecross/blueshield of Tennessee

Hello, I live in California & have BCBST as my health care insurer through my wifes work.  I was approved for gastric bypass surgury by my doctor, but then the surgury department gave me a questioneer to fill out, the second question on the form was " Do I have benifits for obesity related surgury due to medical necessity?"  I called the 800 # on my medical card & asked that question and I was told NO.  Now someone on one of the other boards here just told me that they have the same insurance (bcbst) and that they were approved relativly easily. Does anyone here have BCBST?  Please tell me what you were told???   thank you very much. Greg.

The last company I worked for had BCBST and I was told the bariatric surgery was written as an exclusion on our policy. If your company offers different plans, find out which plans if any allow for the surgery.....if you are on a plan that excludes it, ask your company about changing plans. I really get frustrated with the insurance companies that battle paying for the surgery. The expense of the ongoing health issues would far outway the expense of the surgery......well that is my opinion anyway. Good luck....hope you get coverage..... Janice

Every BCBST plan is different depending on the employer. There is a rider that must be added by the employer and it is very expensive. The company I work for has BCBST and we looked at adding the coverage. With health insurance premiums already very high, the decision was made to not offer the coverage which would have driven the premiums for everyone even higher even though only a few would have benefited from the coverage.

You may check to see if the employer does offer a plan that includes WLS or you may be able to find coverage somewhere else that would cover it. Good luck!

Contact your benefits person at your wife's work.  They will know what if any exclusions there are on gastric bypass.  It is up to your employer whether or not its covered.... my employer is self insured and pays bCBST to process claims.  I had to go through special mandatory requirements. Call BC and ask them too.  Or you can visit BCBST.com and it might be in there.