Premera Blue Cross

on 7/9/07 1:06 am - Lithonia, GA
Has anyone had any experience with Premera Blue Cross Washington?  There is a written exclusion for any bariatric procedure, but when I called they told me that it would have to be reviewed for medical necessity.  Can you see my confusion?  I have been reading diligently about other experiences with insurance.  It was my understanding that once you have a written exclusion there is no hope, but on a few experiences, I have seen that people still get approved even with exclusions.  I need to clarification and any advice of how to proceed?
gary viscio
on 7/9/07 1:13 am - Oceanside, NY
RNY on 07/01/03 with
It is very common to hear two or three different things.  Make sure you get the policy you have in effect and read it, otherwise don't rely on anyone.
Gary Viscio
RNY 7/1/03  -166lbs
Denisha V.
on 7/9/07 1:52 am - WA
from my experience the only company in washington that has premera is microsoft. I used to work for virginia mason and they have an exclusion too. If you are not getting a straight forward answer from the insurance company, call your human resources because the hx is that at least one person has asked that same question and they know exactly what the answer is because it is your employer that made the exclusion, not the insurance company. Hope this helps!