Question:
VA insurance
Hello I have insurance with BCBS Healthkeepers and just really looked over my policy and found out that it excludes anything involving obesity. As soon as I get the courage to step forward seems like I always get stopped! Is there any way the doctor could assist or anything anyone knows about other types of ins or what I can do I'm really needing some help. Thanks for anyone who responds. — Lovemyself (posted on November 23, 2007)
November 23, 2007
Most insurance companies cover at least the Roux-en-y bariatric surgery
today. Insurance companies have found that the cost of the surgery is
cheaper than long term care for the result from obesity--like heart attack,
stroke, joint replacement, diabetes, etc. I have Kaiser insurance and I
live in California. They paid for everything. If you ask your doctor, he
may recommend you for surgery. There are normally some qualifying factors,
such as BMI of 40 or more. BMI can be figured by putting those letters into
Google, and finding a free BMI calculator. OR, if your BMI is under 40, you
may need 2 or 3 "co-morbid" conditions--such as hypertension
under medication, high cholestorol under medication, diabetes, joint
swelling from weight, sleep apnea, etc. Good luck.
— Dave Chambers
November 23, 2007
My policy stated that there was no coverage except for morbid obesity. Now
it was hidden away in the exclusions and when I asked the customer service
rep for a copy of the exclusion, she sent me the whole 100 page policy. I
know the company (Anthem, BCBS) was trying to hide that fact. Check the
wording of your policy and read the whole thing, there may be a loophole.
I was approved in 3 days, so I guess they wanted me not to pursue it at
all. Good Luck and keep going! Don't give up now!
— Debbi S.
November 24, 2007
Bariatric surgery is no longer just for obesity. If you have other issues
that the surgery would be corrective for such as acid refulx disease,
obstructive sleep apnea, diabetes (and the list goes on), your doc can
probably get your ins to cover it. I had this same issue and it took about
a couple appeals and about a year, but my doc finally got it approved and I
am scheduled for December 13. They key is to have a doctor that will go to
bat for you. Dont give up.
— [Deactivated Member]
November 24, 2007
I'm not certain why your message was titled "VA insurance", yet
there was no mention of 'VA' in the body of the message. If you are covered
by the VA (Veterans Administration) and BCBC is your co-insurance, there
may not be a problem. If the VA thinks you need a procedure that is not
covered by co-insurance, then the VA will probably cover the whole thing
regardless of what BCBS wants to do. You should check with your local VA
hospital administrative offices. Let them do the haggling with BCBS if they
want to.
— [Deactivated Member]
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