Question:
What are your options with BCBS if your policy has an exclusion ?

We have BCBSof LA thru my husbands employer . It has a WLS exclusion do i have any options ? We didnt know of the exclusion until after dr avera ins clerk called to get precert . Does anyone know if it would be possible to transfer my coverage to another BCBS policy that doesnt have an exclusion ?    — Mama_G (posted on February 25, 2009)

February 25, 2009
http://www.obesitylaw.com/ Here is a great resource that might help you. Good luck!
   — maggiesmiles

February 25, 2009
I once had a plan with BCBSTX that had a WLS exclusion. Once I talked to a representative on the phone, they strongly encouraged me to fight for the surgery, but I didn't realize that the lady was trying to tell me that if I appealed the decision, then the surgury would get approved. Basically I am saying appeal the decision before you change insurance companies.
   — [Deactivated Member]

February 25, 2009
exclusions ate not a product of the insurance carrier, but at the request of the company- in this case your husbands employer. you will have to talk it over with the hubby, then make appnt with hubby's HR/medical ins person, and ask them to remove the exclusion for just your case. If you get the meeting, be sure to take your medical reports to show them why the surgery is necessary to your health and wellbeing. Many times the employer will over turn it for the one patient. Just remember the ins co is only taking orders from their client. Good luck Cindi m.d. retired -230#
   — DollyDoodles

February 25, 2009

   — nursenut

February 25, 2009
I work for the county here in Ohio and we can buy into different plans as you do but this can be done only once a year - in December. In my opinion the best idea is to appeal unless there is another option I'm not aware of.
   — Muggs

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