Question:
My insurance changed from Anthem BC/BS to Great WEst/One Health Plan.

I was in process of approval when change occured and I was told that this was exact same coverage as Anthem. I am in process again and Great West tells me that there is a exclusion on my policy that they don't have to cover treatment for morbidly obese. What recourse do I have when I am denied to get them to approve? They apparently told the employer that they were exact same coverage and they aren't giving me the same coverage. What do I do then?    — Donna R. (posted on January 2, 2003)

January 2, 2003
Well, here's a couple tidbits. We had Anthem-Great West! They approved my revision in about 3 hrs. And another tidbit. We had a similar situationn (other companies) and went to the eployer & said, HEY, not the same, and the employer fixed the problem. And it was a small company. You're not done yet!
   — vitalady

January 2, 2003
As of January 1st, my company also switched to Great West Life. My suggestion would be to call the 800 number on your insurance card and ask them for their guidelines for getting approved. The guidelines that I was given were a little more stringent than the ones that I was given from our previous coverage, but most of its standard procedure..diet histrory, psych eval, bmi of 40 (35 with comorbs), etc. The number that I have for member services is 800-663-8081. I could send you a copy of the guidelines that I was given. Differences in plans could exist, but you can at least see what they want. My direct email is [email protected], if you are interested.
   — Jaime H.

January 2, 2003
I have Medcost/GreatWest/Onehealthplan. They are all the same, even though they don't look like it. I was approved in less than a week. Don't give up hope, just make sure you have all your ducks in a row. Call them and ask them EXACTLY what they want. Good luck!
   — April A.