Oklahoma, the ACA, and BCBS of Oklahoma

Bear with me because this is somewhat confusing; I'll try to explain it as best I can.

I recently got a BCBS of Oklahoma insurance policy through the ACA exchange website. From what I read through various weight loss forums it seemed like Oklahoma isn't one of the states that has to include bariatric surgery.

Then I started researching more about ACA and bariatric surgery and came across things like this stating oklahoma mandates that it has to be included in all policies on the exchange:

ACA Health Mandates For Obesity

NOFUSA Health Insurance Covers Obesity

(Here's a little background on the state benefit mandates; not required reading, but if you're interested):

State Benefits Mandates 

Well, here's the plan that I bought on the exchange; note toward the bottom it lists bariatric surgery as covered, no charge after the deductible, and under the "Limits and Exclusions Apply" popout, it says "Only covered if medically necessary."

 My Plan on the ACA Exchange

Here is what BCBSOK says about medical necessity and bariatric surgery. Note: This is just what BCBS of Oklahoma says in general about bariatric surgery; I haven't been sent this with my policy or anything like that:

 BCBSOK Bariatric Policy

Yet in my benefits book, this is what it says concerning bariatric surgery: (on page 48, under exclusions) Note: It's a sample page, but it says the same exact thing in my benefits book.

"For treatment of obesity, including morbid obesity, regardless of the patient's history or diagnosis, including but not limited to the following: weight reduction or dietary control programs; surgical procedures; prescription or nonprescription drugs or medications such as vitamins (whether to be taken orally or by injection), minerals, appetite suppressants, or nutritional supplements; and any complications resulting from weight loss treatments or procedures."

Insurance Policy Form

 

So, Oklahoma has to include bariatric surgery in their plans, mine does, but it's also excluded? What?

I emailed the National Obesity Foundation (the 2nd link I posted) patient advocates to see if they could make heads or tails of this. One of their lawyers got back with me and I sent her all of this information. It's the weekend so I don't know when they'll get back to me.

What do y'all think?

I've in the same boat. I have Anthem (BC/BS) in Oklahoma, but have been told by customer service WLS is specifically excluded.   I verified this through two different WL surgeons.  One was a referral setup by Anthem.  It is really frustrating.  Did you ever get an answer?  Anthem is the only option I have through work unless I have military insurance.