Question:
If your Surgeon is on your provider list, does this mean the WLS is NOT an exclusion?

I have already been approved; my friend is researching WLS now also. I looked up my surgeon on her PPO provider list and he was on it. Does this mean that WLS is not exclusion? (She has BCBS of IL.)    — Rebecca P. (posted on July 24, 2002)


July 24, 2002
No, the surgeon can be on the list without WLS being ok. He may do other types of surgery also.
   — jen41766

July 24, 2002
Hi, I also have BC/BS, but I would (and did) call the customer service number, should be on her cards, and ask if there is any exclusions to WLS. BC/BS policy, usually, is that they have to 100 pounds over weight, or have co-morbidities. However, some companies that hold the contract have policies against it. This would usually be the employer. Have her call them, I had approval in 1, yes, 1 day!! Good luck!
   — Terri Z.

July 24, 2002
Check with human resources at her job. If there is an exclusion, it will be with her company. As of Jan. 1, 2002 BCBS has stated they will exclude WLS - but if her policy is with a company that DID NOT have the exclusion before, and if she had the policy BEFORE 1/1/02 - they will honor it. I just went through all this. I have BCBS of TN, through Bridgestone/Firestone. They did not have an exclusion and I have had the policy since 1998. I was approved in 3 days. Good Luck.
   — Pam G.




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