Hello, I've been going through the process since early January, the nurse called BCBS of FL to see if it was on my policy on day one, they told her it was, I went through everything for it, they submitted for final approval and BCBS said it's not covered, apparently Bariatrics under a single person Obama policy is excluded, even the Platinum coverage which I currently pay $450 a month for, my question is has anybody recently had success with BCBS of Florida and/or what plan do you have in Florida that covered it.

Thank you very much for your help

Stuart

^{I'm so sorry mine was not covered through my job BCBC of Tennessee so the Bariatric Dr I saw told me about Mexico because I was crushed my PCP agreed with him co im having mine July13. Good luck to you:)}

Just curious, did you actually look at your benefit plan before going through all that? I knew my insurance coverage before I even started.

No, I did not, I trusted the doctors office that called and was told by BCBS that it was covered, when is dealing with an insurance company ever easy and to go through my benefits book, if I knew where it was, wouldn't have been easy either, why I figured the office knew what they were talking about when they said yes, it was covered.

I barely feel comfortable having the surgery done in my town, let alone having it done in a foreign country a couple thousand miles away where nobody speaks english, may as well have the surgery in Florida would be the same thing, HA! I don't know if I mentioned this I am in NY, not Florida where my policy is, as I am a Florida resident, not a NY resident.

That's crazy the same with me mine is BCBS of Tennessee and I live in Az.

Yeah - I have BCBS of Mass - and I live in NY!

Yeah - I have BCBS of Mass - and I live in NY!

What happened?

Medical Tourism is big business in Mexico. Check some of the links on this site and you will be surprised how many doctors and staff are bilingual. When it comes to medical tourism, English is the lingua franca for services. Several of my American born doctors studied abroad, whether it was Guadalajara, Grenada, Italy or Spain. As for affordable care act issues, the compromise for what individual states consider essential health services was to appease states with low levels of acceptable public services. A lot of compromises were made and the winners were the insurance companies. When I was a kid in Florida I use to hear horror stories of uninsured people being discharged from hospitals as soon as they were stabilized.

Edited June 10, 201511 yr by Nikasio

Nothing yet, Bobbe - my surgery won't be until Sept or Oct - just hoping it will be covered.

Was really commenting on the vagaries of the ins co's. Stuart lives in FL but has BCBS of NY (or vice versa). Kiki lives in AZ but has BCBS of Tennessee.

No wonder people have a hard time figuring out if they're covered - and that includes the MD offices, too.

Sorry if I added to the confusion.

Here is a table by state of coverage for weight loss surgery under the Affordable Care Act:

http://nofusa.org/news/health-insurance-cover-obesity-treatment/

There is also other information about financing and coverage. The state of NY offers bariatric surgery as part of the ACA. Perhaps a move to NY since you are there already is in order?

Here is a table by state of coverage for weight loss surgery under the Affordable Care Act:

http://nofusa.org/news/health-insurance-cover-obesity-treatment/

There is also other information about financing and coverage. The state of NY offers bariatric surgery as part of the ACA. Perhaps a move to NY since you are there already is in order?

One would think the drs office would know that website, as I'm sure I'm not the first one from out of state to want coverage ...

Thanks

Why don't you switch to the NY coverage. I lived there and never formally changed residency from Florida and was still able to get insurance, plus didn't have to pay a dime since I made under $90,000/year with a family of three. This was before the Affordable Care Act. Try and see if you can change insurance companies. Plus NY covers bariatric surgery.

I went through this whole bariatric process a year ago, lost my job so of course lost insurance. I looked into obamacare and while some states DO cover it, there are a handful who DO NOT. I know its disheartening, I'm sorry.

Why don't you switch to the NY coverage. I lived there and never formally changed residency from Florida and was still able to get insurance, plus didn't have to pay a dime since I made under $90,000/year with a family of three. This was before the Affordable Care Act. Try and see if you can change insurance companies. Plus NY covers bariatric surgery.

They verify you are a NY resident now so I can't just get a NY policy

I am so sorry this happened to you. I had to self pay for my surgery since I am a state employee in Texas and Scott and White insurance will not cover it. It is insane that the Scott and White Hospital is a Bariatric Center of Excellence and has excellent surgeons, but they will not cover the surgery. They do accept other insurances, but I cannot just switch insurance mid stream, have to wait for enrollment, which would not really help me. I know how you feel.

Can you maybe get a low interest loan to do self pay? They typically will do a special rate for self pay patients. I do not know the cost in Florida, but Texas is (fairly) reasonable about 6-15K depending on where you have the surgery.

Hang in there.

I have BCBS and it specifically says that bariatric surgery is not covered.

I'm being sleeved in Mexico in a few more days for just a little bit more money than what my out of pocket maximum would have been even if they covered this surgery.

Good luck!