Question:
Anyone been approved by BCBS PPO for BPD/DS?

My BCBS PPO policy covers RNY and Lapband but does not cover BPD/DS but they do have a "Individual Consideration" clause that states: All our medical policies are written for the majority of people with a given condition. Each policy is based on medical science. For many of our medical policies, each individual's unique clinical circumstances may be considered in light of current scientific literature. For consideration of an individual patient, physicians may forward relavant info to BCBS. Has anyone been approved for BPD and/or DS by BCBS PPO? Thanks!    — here_is_the_deepest_secret (posted on September 24, 2007)

September 24, 2007
What BCBS do you have? There are too many different BCBS's to count and it depends on the group policy. There are attachments to all group policies like maturnity, cancer and even bariatrics. So it just depends if your group has it added to the policy. The only reason I know this is I work for BCBS of OK, which does not cover any weight related issues, but I have BCBS of IL coverage, which does. Crazy isn't it.
   — dee77

September 24, 2007
It is BCBS of Mass. "Blue Care Elect Preferred" and is through my university. Thanks for your response!
   — here_is_the_deepest_secret

September 24, 2007
I have Anthem BC/BS. I live in KY. And I had Lap Band surgery last Tuesday (9/18). Really didn't take to long to get a approval. Joann
   — Joann King

September 24, 2007
Hi Melissa, That is how our BCBS PPO policy wording of MN was written.. I had co-morbities and a BMI over 40 and was approved quickly once it was made clear to the insurance company what was needed. So file for the "individual consideration" and remember the BPD/DS is no longer considered experimental by Medicare, so that means BCBS is approving them quicker these days. I am 4+ yrs out from my DS and so thankful for it ! Let me know if you have additional questions. Blessings, Ginger <><
   — gak

September 25, 2007
I have BCBS in FL, my husband is a federal employee and I had many commorbidies. It didn't take very long for approval. Good luck!
   — blazedear