Blue Cross Blue Shield of Texas
You are correct. I had Blue Cross Blue Shield of Texas and the policy my employer chose has the WLS exclusion. Now we have United Healthcare and its the same problem.
The insurance companies put the clause in the policy and the employer picks a policy that fits their budget such deductible, copay, prescriptions, etc. They dont look at the exclusions when considering the policy.
So I am back to square one either have to fight with the insurance and get them to approve or pay cash.
Shanna
The insurance companies put the clause in the policy and the employer picks a policy that fits their budget such deductible, copay, prescriptions, etc. They dont look at the exclusions when considering the policy.
So I am back to square one either have to fight with the insurance and get them to approve or pay cash.
Shanna
I just started a new job in Virginia (and I live in Maryland) but the insurance is BC/BS of Texas (and that was the only choice) and my heart sank when I read that exclusion clause. I was looking to see if it was firm or whether the appeals process would reverse it. It's taken me years to come to the decision for surgery, I have two different co-morbidities that would qualify me, plus a BMI of 45 (but before No S, it was over 50), and in the long run it would be cheaper for them to pay for the surgery.
I canceled my first appointment with the doctor (made when I was employed at the old job) after reading the exclusion clause in the new hire packet, but if someone here has jumped through the hoops to get an exception I'll start the process up again. I just don't want to take time off from work when I don't have any leave time if it's going to be a waste.
Financing is not going to be an option, not with the double whammy of a kid in college AND living in one of the most expensive regions in the country. (By way of illustration, I pay $1350 a month rent on a 990 sq ft townhouse.)
I canceled my first appointment with the doctor (made when I was employed at the old job) after reading the exclusion clause in the new hire packet, but if someone here has jumped through the hoops to get an exception I'll start the process up again. I just don't want to take time off from work when I don't have any leave time if it's going to be a waste.
Financing is not going to be an option, not with the double whammy of a kid in college AND living in one of the most expensive regions in the country. (By way of illustration, I pay $1350 a month rent on a 990 sq ft townhouse.)
Hi All,
I'm a newby to this so be gentle. Anyone have any experience with Scott and White Health Plan and their exclusion for WLS? I'm a State of TX employee and I may have to change my coverage to BCBS of TX, only because ERS has just added that they will pay $13k to WLS with my deductable being $5k plus 20%. I guess that's better than nothing.
Thanks!
Laurie
I'm a newby to this so be gentle. Anyone have any experience with Scott and White Health Plan and their exclusion for WLS? I'm a State of TX employee and I may have to change my coverage to BCBS of TX, only because ERS has just added that they will pay $13k to WLS with my deductable being $5k plus 20%. I guess that's better than nothing.
Thanks!
Laurie
Wish I had some words of wisdom for you but I have never had either insurance! All I can tell you is having the surgery is one of the best decisions I have ever made. I love my tool! I had RNY 3 yrs ago, have lost 165-170lbs (depending on the day of the week) and have been at goal for 1.5 yrs. I have not had a typical journey but even with my complications I would due it all over again in a heart beat!!
Welcome aboard the TMB (Texas Message Board) and chime in any time with questions. The weekends are usually pretty slow, especially holiday weekends so you may want to post your question again tomorrow or Tuesday morning!! Don't just lurk around join in!
Meggie
Welcome aboard the TMB (Texas Message Board) and chime in any time with questions. The weekends are usually pretty slow, especially holiday weekends so you may want to post your question again tomorrow or Tuesday morning!! Don't just lurk around join in!
Meggie
Megan
I think I am ready to to start fighting the insurance company. I am now on United Health Care and still have the same exclusion.
I am so happy to hear you have lost soooo much weight. My daughter had the RNY the end of October 2009 and has lost over 70 lbs. She had a lot of complications too but she conquered them and she looks so good. She is a small frame person but I had forgotten how small she should be. She has done so well!!
Shanna
I am so happy to hear you have lost soooo much weight. My daughter had the RNY the end of October 2009 and has lost over 70 lbs. She had a lot of complications too but she conquered them and she looks so good. She is a small frame person but I had forgotten how small she should be. She has done so well!!
Shanna
GO FOR IT SHANNA!!!! You have nothing to loose but weight! A small word of advice start changing little habits now to get yourself ready for life after the surgery. If you change them a little bit at a time life post wls is easier and not such a shock to your system! Keep posting and asking us quetions and we support you all we can.
Congratulations to your daughter too!! Have her join us too she would be a great inspirations to people here also and we would love to get to know her too!
Meggie
Congratulations to your daughter too!! Have her join us too she would be a great inspirations to people here also and we would love to get to know her too!
Meggie
Megan
bCBS of TX - I attended my first meeing at Celebration Bariatric May 2010. Scheduled 6 consectutive monthly visits with my Primary Doctor and the Bariatric Centers Nutritionist. My application was submitted yesterday 11/18/2010 to BCBS of TX. It was approved today 11/19/2010. I am awaiting a call from Celebration Hospital to schedule my surgery.
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