Question:
Why do some BCBS approve WLS and some not.
Mine insurance is BCBS of SC. Does it matter who the employer is. Mine is through Winn Dixie stores. It has a weight loss exclusion. Is it worth fighting for? My surgeon says I qualify for surgery. What next? — Tina T. (posted on May 1, 2003)
May 1, 2003
Hi Tina. We've had two individuals within our support group get approval
after lengthy appeals with Winn Dixie. The only company with a more
difficult exclusion is WalMart. The reason some BCBS covers it and other
don't is because employers choose what they want included in their policy
and what they don't. It seems that it would make more sense to campaign
with the powers that be at Winn Dixie. At renewal they can change the
exclusions and inclusions of their policy. Good luck to you!
— ronascott
May 1, 2003
It does matter who the employer is. They are the ones who buy the policy
from BC/BS. There are cheap policies (ones that have exclusions for
expensive wls) and ones that are better. It just depends on what policy
your employer bought.
— ZZ S.
May 1, 2003
It can also matter what state you live in. There are a few (FEW) states
that mandate coverage for WLS, so that can also be a factor. For some
reason, BC/BS seems to be a couple of hundred different companies,
depending on where you live or where your employer has its main office,
etc.
— garw
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