Question:
as of 7/05 any word on bcbs not covering wls?

   — nicole K. (posted on July 26, 2005)

July 26, 2005
It totally matters what policy you have and where you live etc. My husband just got approved in 2 days by BCBS United of WI. Our policy is only andministered by BCBS, so it is the State of WI that decides if it will cover the WLS. However, BCBS has the say on whether it is medically necessary etc. I do not know if BCBS in WI is covering WLS as part of their normal PPO's or not. Best thing you can do is call and ask!
   — zoedogcbr

July 26, 2005
I don't think BCBS itself will ever stop covering WLS...it all depends on the plan and the employer. I have BCBS of IL, and my employer bought the WLS rider, so it's covered. I guess what I'm saying is it depends on so much more than just BCBS...there's lots of other factors involved. Good luck to you!
   — ShelleyLuvsMinPins

July 26, 2005
I have BCBS of Louisiana PPO plan. Had NO problem getting approved. All it took was the letter from Dr.O'Connell. Had my surg 13 weeks ago.
   — callon56

July 26, 2005
I have BCBS of NY. They covered my surgery which was 6/17/05
   — mzb2u

July 27, 2005
I have BC/BS (teamsters)and according to theirs you have to have a BMI of 40 or over. See a therapist, 1 year medically supervised diet (I am 9 months into that). Call your ins and ask or look in your plan book?
   — [Deactivated Member]

July 27, 2005
Been working on it for a year and BCBS of Tx is denying. I'm still working on it.
   — Shanna M.

July 27, 2005
It's not a question of BC/BS covering it--it's a question of your employer's coverage. If they have elected to have WLS left out of the plan or it is an exclusion to the plan...you will not get approval. If, however, your plan is through your employer and there is no exclusion, it may take an appeal or two, but if you meet the criteria for medical necessity (most insurance companies base their criteria on the guidelines provided by the N.I.H.) then it will be approved. If you have a private plan or individual plan, it is probably excluded...you'll just have to grab a copy of your plan booklet.
   — Pamela S.