Question:
Is it covered or not??? I have BC/BS PPO Select. Coverage began 4/1/01.

My employer enrolled me on 3/18/01. I have not seen a doctor since Aug. 14, 2000. And yes, it was for my weight. I have a 12 month pre-existing waiting period on my policy. However, if the condition has not been treated in the prior 6 months, it is suppose to be covered. But, BC/BS will not pre-approve. They just say that it will be reviewed after the procedure is done. I can't afford to pay for this out of pocket and I need to get back to work. It's either this along with possible bladder suspension and gall bladder removal or double knee surgery! What should I do? Will the surgeon go ahead with this? Is it common? I keep getting pushed around at BC/BS. Any direction to go on this would be much appreciated.    — [Anonymous] (posted on May 8, 2001)

May 8, 2001
I have BC/BS Federal Anthem and they covered all of it no problem. I am also in Ct.I was approved in 1 day and also was my husband for the same surgery. We had surgery a week apart and both was covered. Alot has to do with your surgeons remarks on the diagnosis as to the necessity.
   — Debra N.

May 9, 2001
I have BC/BS of Ill PPO - select. My RNY was approved. Once they received all needed documentation, they approved within 4-5 days. Ask to speak to speak with someone on the rewiew board at BC/BS. The first time I called the insurance company, I was told basically the same thing you were. However, my surgeon required written documentation so I ended up having to be "pre-approved". Good luck!
   — Margaret B.

May 9, 2001
When I was researching insurers, the one thing I found out about BC/BS is that they usually require that you have been morbidly obese for at least five years.
   — PT LawMom