Hi I have Blue Precision HMO I chose this because this was only plan i could some what afford with my part time income. And it said they covered bariatric surgery. Then the insurance person at the place I will be getting the surgery done called me on Friday and told me there is an exclusion and it not covered.... I know it is a HMO i know I need to go through my PCP first but why is it saying it's not covered when i went through the exclusion packet part and it does not say anything about it. And right before I bought the insurance the reps said it is covered on my insurance, this was only reason I bought the insurance and paying a whole paycheck for it... idk any info or insight would be nice. I have 8 days to opp out of this insurance if i don't like it so kinda running on time.

Hi,

Based on the document you attached it looks like bariatric surgery is covered but weight loss programs are not covered....that is referring to the non surgical programs. this document doesn't tell you what the medical requirements are for surgery but at least it's not excluded.

I would call the insurance again and give them the CPT code for the surgery you plan on having. Than ask them to direct you to the medical policy which will show their requirements for surgery. The CPT code will let you know if the particular surgery you want is covered under your policy. That document shows your insurance company covers Bariatric surgery but we don't know if your individual policy does. Good luck!

Sent from my iPhone using the BariatricPal App

Edited April 3, 201610 yr by LadyWarren