Insurance help

Hello, I have Anthem and am told that my specific policy does not have the ryder for WLS, so I shouldn't even bother with further requests. This is VERY discouraging, and I'm wondering if anyone else in VA has run into this problem? Also, I recently read (and was told) that after July of this year (2006) a lot of insurances are dropping WLS from their policies. Does anyone have any further knowledge of this? I'll appreciate any info you have. Thank you, Elizabeth

G'morning Elizabeth ~ I don't know anything about ANTHEM, but Ive seen that insurance carriers name brougt up several times on the VA-boards, so hopefully someone can address your question. As far as MORE insurance companies dropping WLS after the middle of the year, I'm sure it's VERY possible. Ive been on the OH boards for about 5 years now and unfortunately EVERY year, more and more do follow suit. I never did understand the 'reasoning' behind the decision, since I believe that severe obesity dictates MORE health problems and EXPENSES in the long run, vs, the immediate cost of WLS. Unfortunately, more times then not, big companies and their bean counters look at "immediate" gratification, costs/expenses, vs, the long term results. Good luck to you - Lei

Good morning Elizabeth, I don't know about Anthem either but I wouldn't figure that insurance companies would (or could) change coverage mid-year but then again I never thought that I could lose my pension without notice so...anything's possible! Good luck! I have also seen many people with Anthem on these boards...I'll bet someone knows a "trick" or two! Christine

Good morning Elizabeth!! Again, I don't have specific info on Anthem, BUT, I did have the same issue as you with no "rider" on my policy. Turned out to be a bunch of lies though.....................get your evidence of coverage book. Don't put it off like I did. It will specifically state the WLS coverage. Please go read my profile..............my ins. company said flat out...........no way, no how. My drs office had never had approval from them. GUESS WHAT..................not only did they pay, they paid every fricken penny!! Ya gotta want it girl, and ya gotta fight!! Best of luck to you!! Sincerely, Sharon

Hello all, Thanks so much for your replies to my post. I'm not sure if an evidence of coverage book is the same, but in the employees handbook, it does state that WLS is not covered. I'm expecting them to switch insurance companies next year.. I'll just hope that MAYBE I will have some luck there. Thanks again for all your info! Elizabeth

Hey Elizabeth, I don't have Anthem but I do have Highmark Blue Cross & Blue Shield. I have been trying to get an approval since July 05. I am now in my 3rd month of a medically supervised diet that they require you to go through before they will approve you for the surgery. Many of the insurance companies are tightening down since so many obese people are going this route to regain their health and their life. I agree with Lei about the benefits vs the cost. In the long run they would be better off to make sure we are healthy rather than worrying about the cost of this surgery. I will keep you in my thoughts and prayers as you begin your journey and I pray that you will get a speedy answer. Nothing is worse than the wait. Lots of Love Kathy

Hello Elizabeth I have Southern Health. I just posted a help thread myself. I work for a small family owned business and WLS is something that he doesn't have in our insurance package so it's not covered. Is that the same thing as not having a rider? I'm not sure of the terminology. I'm a little nervous because I want this surgery some kind of bad and although I am determined, $18,500 is ALOT of money. I'm keeping my chin up, hope you do too!