Question:
Denial BlueCross PPO-Anthem of Ohio/Indiana Appeal?

I am in Michigan but insurance is out of state BCBS Ohio/Indiana. I have BMI of 59, sleep apnea, GERD, High Blood Pressure, Insulin Resistance, severe Asthma, Back & Foot Pain, High Cholesterol & Triglercerides. I have been off and on diets my whole life. Family history of severe obesity & diabetes. My isurance policy says it specifically cover WLS surgery for morbid obesity if considered medically necessary. BCBS just denied me saying that they won't cover it until I have been on a Dr. supervised diet for 12 consecutive months of which they will not pay for. I have already been on all the major diets. Should I and what do I need to do to appeal?    — Dell H. (posted on August 31, 2001)

August 31, 2001
I too have Anthem BC/BS here in Indiana and have been told the same thing as you. I have done the 12 months of Dr. supervised dieting and am still being denied. I am in the process of trying to appeal this again. The only thing I can tell you is to talk to your PCP about putting you on a diet, go in for visits and try again......they definitely WILL NOT change their minds until you've had at least 12 months or get a letter from your PCP stating the medical necessity of this surgery! Good luck and don't give up! Jean
   — jeannieree