Question:
HAVE ANYONE HAD ANY PROBLEM WITH BCBS BECAUSE OF PCOS

I WAS WONDERING IF ANYONE WITH BCBS HAD ANY PROBLEMS AFTER THEY PUT PCOS AS A MORBID OR PUTTING IT DOWN HELP.    — MARLO M. (posted on December 9, 2003)

December 9, 2003
I got approved on the first try with BC/BS and I put down PCOS. It is know that having PCOS makes it ten times as hard to lose weight on your own. I am also noncyclic which means I don't have a cycle at all. These were both putin my file and sent to the insurance company and I got approved no problem. It couldn't hurt.
   — Tabitha D.

December 9, 2003
I have BCBS of NC and I have PCOS. I was approved the first time. The only thing that could be a "bad" co-morbidity could possibly some type of thyroid problem. But most people have had some type of treatment with thier thyroid problem. But I seriously doubt that having PCOS would harm your possible approval for surgery. Good Luck!
   — Ashley S.

December 9, 2003
I have PCOD and they listed it on my submission for approval. I got denied the first time around because they said if was not medically necessary. I met ALL the requirements and had letters from 14 doctors stating I needed the surgery. It was brought up about me having PCOD, but nothing ever came of it. I ended up gettin my approval last friday and I am scheduled for surgery on DEC 26th 03. Good luck! TreAnn
   — FlippyChick 33

December 9, 2003
I had Trigon (now Anthem) which is BCBS of Virginia at the time of my surgery and was approved within a couple of days. PCOS was the only major medical problem I listed on all my paperwork. I certainly have a family history of diabetes, high blood pressure and high cholesterol, but I myself had not developed any of these yet. All the BCBS plans differ from state to state and employer to employer. If you have been denied, you are owed an explanation as to why. Some plans or employers exclude all WLS, so whether you have PCOS might not have anything to do with it.
   — Ali M

December 10, 2003
I had BCBS MD (Carefirst) I think putting PCOS helped my case. I had a list of other problems to go with that. Best Wishes
   — Tie C.

December 10, 2003
I have BCBS IL PPO, and having PCOS helped me. I will say that I was denied and had to fight like heck for the surgery (they wanted me on a dr. supervised diet), but I wrote a great appeal letter and was finally approved. I can e-mail it to you if you like...
   — Amy E.

December 11, 2003
I have BC/BS of Minnesota and I was approved the first time. I have PCOS plus high blood pressure, that is just the begining of the co-morbities. Ususlly BC/BS says that it must be medically necessary for approval. I was impressed with the responses I got from the comapny. Had my surgery on Sept. 26th and I am down 60 pounds "Not to shabby" =0) Good Luck to you Marlo
   — CARRIE C.

December 11, 2003
I too have PCOS and my insurance is BCBS of WY. The first time they denied me for the surgery (2 years ago) and I went to a different doctor and was approved the first time out with him. I would think that the people doing the medical review would know what PCOS is and how it can effect our bodies - maybe they might need a letter from your doctor or OB/GYN stating how it effects your body, side effects from it, infertility, etc. Good luck with everything
   — Carol S.

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