BCBS OF TEXAS

[mekac1290 0]

I need HELP I have bcbs of tx through my employer and was told there is an exclusion for weightloss surgery. I actually found a doctor that does surgery for people who have a hiatal hernia and the out of pocket is not very expensive but the coordinator tells me my insurance does not cover hernia repair either. I refuse to give up just looking for some advice is there a way around this?

[anneeo 13]

I would think the hernia repair would be covered, I'd double check on that. I also have BCBS of Texas and any WLS is specifically excluded. Sadly, that's not unusual to have the exclusion in small business group policies or individual policies. If you have the option to change insurance companies at work, I'd check into it.
Your best bet would probably working for a large company and getting group coverage thru them.

A couple of years back I looked into the state pool, insurance for people that can't get coverage elsewhere. At the time the surgery was covered. However, coverage is much more expensive and by the time I could apply, I discovered that they had excluded the coverage.

Is there any chance you could finance it yourself? I know there are companies that will finance medical expenses.

I've been wanting to do this for about 10 years and even though I have to pay for it all, I've decided to go ahead.

Best of luck to you!

[ElleLB 17]

Same here :/. I have BCBSTX through a local school district. My employer elected not to cover WLS, but I do have general benefits that would cover the hernia repair…HOWEVER, it would have to be at one of the in-network facilities and all of the places that offer the surgical discount w/ hernia repair are out of network. Bummer!

I've decided not to let the insurance thing hold me back. Headed to Mexico w/ Dr. Alvarez in March.