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For those of you with BCBS. Did your handbook spell out NO coverage for any weight loss surgery even if medically necessary. Mine does but I was wondering if I should try anyway

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It must just be your plan. I have BCBS Blue Options (NC) and they cover it all. I just got my approval today and am scheduled for 12/19/12. Keep trying, you can fight it. If they still won't cover, think about personal financing. From all the research I've done, it's definitely worth it! Good luck!

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For those of you with BCBS. Did your handbook spell out NO coverage for any weight loss surgery even if medically necessary. Mine does but I was wondering if I should try anyway

I have BCBS and it says the same thing. There is no way WLS is covered. Sorry. (I'm doing self pay)

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There are many different BCBS plans. Each one varies and you have to call. Some have exclusions specifically against it and some have requirements and restrictions.

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I have BCBS and it says the same thing. There is no way WLS is covered. Sorry. (I'm doing self pay)

Could y give me an idea of what ur self pay charges were

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Mine was excluded also. I called and called and researched. If its excluded, its excluded. Period. We finally had to look into self pay. It was $18,000 where we live. Or 1/3 of that in mexico. So we took a vacation ;)

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Mine was excluded also. I called and called and researched. If its excluded' date=' its excluded. Period. We finally had to look into self pay. It was 18,000 where we live. Or 1/3 of that in Mexico. So we took a vacation <img src='http://www.bariatricpal.com/public/style_emoticons/<#EMO_DIR#>/wink.png' class='bbc_emoticon' alt=';)' />[/quote']

It is 14000 here in Mobile,Al. I'm a little afraid of Mexico.

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There are literally thousands of BCBS plans which differ according to employer specifications as well as state law. If your book is current and it says it's not covered, it's not covered. Mine covers at 40 + BMI with comorbidities. I was lower than that with no comorbidities so I knew I was going to have to be self pay. Self pay in washington was about $20,000 with all of the extras needed.

One thing you want to know from your book is that if you do go ahead and do self pay, do they pay for complications from non approved surgery/procedures? Mine will be about half a million total we're thinking (we thought it was half that amount but it's still growing). Our insurance is so far paying even though they didn't cover the surgery, which is incredibly rare. You will want to know this because if they don't cover it and you have a complication....well can you afford half a million dollars??????

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I have BCBS and my original handbook said no coverage. When a representative was at my place of employment, I asked and she said sometimes it is covered. So I went ahead and met with a surgeon and they felt it would e covered. I got my approval letter today. Surgery is scheduled for Jan 7th and they said it wouldn't be a problem to have approval so far in advance of the scheduled date. It never hurts to call your plan administrator and ask.

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I have excelled bcbs and my surgery is on nov 27 and is covered in full. Best thing to do is call the insurance company directly.

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I hve bcbs and had surgery on 10/29 bcbs I got thief policy and there were revisions to the policy. As a matter of fact bcbs approves faster than any insurance I seen on the boards.

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I got my approval in 2 weeks.

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I got my approval sent in the morning and by the pm they called me to tell me I was approved! : )

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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    • KimBaxleyWilson

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