Wishing for the day!!

Oh wow, i am really not sure how your insurance works but you have 2 of the major comorbid conditions that make you eligible for surgery, I would think if it was absolutley medically necessary then they should approve it. Our company had BCBS a few years ago and i have a coworker that had the surgery in 08 due to just diabetes alone.

I wish you all the best of luck

File an appeal with your insurance company regardless of the clause in the policy you have life threatening ailments that can be reversed if not cured by losing weight and having the lapband surgery. I would fight this one and call, call, call until they get you approved!! I am surprised that BCBS is turning you down they approve 100% of them in California for the comorbidity issues you have.

I have BCBS of Alabama..they also turned me down so I self paid. I then turned in the receipts. They reimbursed me 50% and they are now paying all of my fill visits to the surgeon. Have the hospital get a pre-admission approval, see if the anes will get a pre-approval as well...the third bill I had was the surgeon..that one you will have to fight. But like I said I submitted the receipts and they reimbursed me 50% and are paying 100% now for the office visits.