I know Ive posted a couple times regarding insurance coverage. So I apologize if my post seem to be repetitive. However, we are in the open enrollment stages of insurance with my husbands company. After much research, it *seems* like BCBS is going to be the best option for me. However, because I dont currently have BCBS, Im getting the run around. To actually speak to a representative, I have to have a client #. I dont have one so I keep getting hung up on. I called the hospital where I want the surgery done and talked to the insurance dept who said that BCBS is *usually* great. But just to check my particular coverage and make sure there are no exclusions...problem is..without actually having that insurance yet, I cant find the exclusions and cant get through to a real person to ask them.

Any suggestions?

The open enrollment packet says "Blue Cross Blue Shield Community Blue".

I have Blue Shield California and thats why I had to self pay...they suck but its probably different for you. I wasnt fat enough and had no comorbs.

I know Ive posted a couple times regarding insurance coverage. So I apologize if my post seem to be repetitive. However, we are in the open enrollment stages of insurance with my husbands company. After much research, it *seems* like BCBS is going to be the best option for me. However, because I dont currently have BCBS, Im getting the run around. To actually speak to a representative, I have to have a client #. I dont have one so I keep getting hung up on. I called the hospital where I want the surgery done and talked to the insurance dept who said that BCBS is *usually* great. But just to check my particular coverage and make sure there are no exclusions...problem is..without actually having that insurance yet, I cant find the exclusions and cant get through to a real person to ask them.

Any suggestions?

The open enrollment packet says "Blue Cross Blue Shield Community Blue".

Did they give you a benefit book to read and compare BCBS is good insurance; however, each employer may have restictions etc on the policy. The name "Community Blue" makes me wonder if it is a managed care product. Check out each policy to make sure you know the weight loss surgery requirements. Good luck.

Melinda

Did they give you a benefit book to read and compare BCBS is good insurance; however, each employer may have restictions etc on the policy. The name "Community Blue" makes me wonder if it is a managed care product. Check out each policy to make sure you know the weight loss surgery requirements. Good luck.

Melinda

they gave us a pamplet. That says its covered but says "see exclusions" but there is no exclusions that I can find. And when I go on the BCBS website the term "community blue" is not listed anywhere in the options. And of course, when you call, you cant get any answers. I feel like Im running on a hamster wheel!

I have BCBS and they have an exclusion for the Lap-Band. Basically I am having to combine a hernia repair with the band placement. I will pay for just the band, insurance will cover the rest. It's about 50%. I have a family member that is an insurance specialist in a large surgeon's practice and she said BCBS across the nation is about 50/50 for any WLS. BUT it really has everything to do with what the employer decides about the coverage they want to provide their employees!

It depends on which policy you have. I have BC/BS from Walmart. They won't pay for any weight loss programs. My Husband works for the State and they will pay 100% with requirements.

Does anyone have any idea where I can find this information. It seems like the info is available if your already a member..but if your looking to switch insurances its almost impossible to find the full info. My husband works for Detroit Edison in Michigan. Its making me insane.

two thoughts

call an insurance broker in the area

and call his HR and see if they will tell you if they exclude WLS.

Hopefully one of the two can give you some answers.

Good luck,

Melinda

two thoughts

call an insurance broker in the area

and call his HR and see if they will tell you if they exclude WLS.

Hopefully one of the two can give you some answers.

Good luck,

Melinda

Thanks Melinda I will definately give that a try in the morning.

Yeah, each BCBS is different. Many small policy companies write out lap-band/similar surgeries from their policy.

I was lucky that my company didn't and BCBS is covering everything. Good luck!