Question:
Anyone with BCBS of IL PPO been denied LAPBAND and fought the denail and won???

I was denied through BCBS IL PPO because "Medical efficacy had not been established' meaning its investigionl and expiermental. Anyone had any luck overturning this? Thanks    — DoxieMom72 (posted on March 8, 2004)

March 8, 2004
I havent BUT I know in my support group people who had BCBS and wanted the DS - BCBS had the same 'mind frame' on that surgery to, they APPEALED and won. If you truly want the lapband APPEAL! and go all the way; the worst is you will loose, then you can go for the alternative then.
   — star .

March 8, 2004
p.s... A good 'point' is BCBS does pay for the VGB and THAT is esentially in practice the same as the LAP BAND except the lap band is BETTER (adjustable) and the VGB isnt
   — star .

March 8, 2004
It is very common for them to deny you with this reason. Many people appeal and win right away. The insurance companies just need a little nudge. Check out the yahoo group for band insurance issues and check out Walt Lindstrom (a wonderful band lawyer who does wonderful things for a small fee): <p> http://health.groups.yahoo.com/group/BandstersInsurance/ <p> http://www.obesitylaw.com/
   — Sheryl W.