Question:
BC/S of TX (State empl)

I work for the state. Our ins. is arranged thru our retirement system and different companies are req'd to bid on the state's business. As such, the ERS specifies that WLS is not a covered procedure. However, I'm wondering if RNY may be a covered procedure if used as a revision instead of WLS. Any comments?    — [Anonymous] (posted on August 25, 1999)

November 11, 1999
I am a state employee in Md. I have bc/bs ppo. There was exclusions but it also had an exception claus. Which stated that morbid obesity that was deemed medically necessary would be covered.
   — Donna S.

December 2, 1999
I just got a refusal from BC/BS Health Select of Texas for a gastric segmentation (that will cost me $10,200 if paid for cash) and was also told that there ARE no appeals until the procedure has already been done. The problem is, of course, as I'm sure it is with most of us, money the the reason we are applying to insurance in the first place. As far as I am concerned this answer is not acceptable. I am very willing to join forces with anyone out there who has any good ideas on how to approach this. This is a medical necessity, not a cosmetic luxury! Let me know if I can help; in the meantime, know that you're not alone in this. Any of you feel free to e-mail me at [email protected]. Maybe together we can get some attitudes changed!
   — Amma D.