Question:
Why do different BC/BS plans ask for different info??

I've noticed that alot of people with BC/BS(I'm in Alabama)are having to submit extra stuff after the first paperwork has been sent. IE: more weightloss history, psychological exam, and other tests. Is each plan so different??? Do they not have a standard to go by?? I just hate insurance companies ! (and here I am trying to get BC/BS to approve me....)    — Susan Z. (posted on August 24, 2001)

August 24, 2001
Susan, I've wondered the same thing, I'll be interested to see if anyone can explain this. I have BC/BS Horizon HMO and will be starting the approval process in the next week or so. I'm choosing to be optimistic since meeting a friend of my sister's who has the same surgeon and the same plan and had no trouble getting approved. She had no more co-morbidities than I do so I see no reason why I'll be denied. But among the many things I've learned at this site, is the that there doesn't always seems to be any rhyme or reason to the decisions of the insurance companies. I personally find them thoroughly confusing.
   — Donna L.

August 24, 2001
I have BC/BS(state of Virginia) and i didn't have any problems the office sent in the paperwork and they never asked for anything else. All that was sumitted to them was one form that had my wieght, hieght, BMI short diet history, my goal and my co-morbidities which on the check list i have 6 and i was approved i less than two weeks So don't be discouraged every case and plan can be different. Hope this helps
   — Amanda P.

August 24, 2001
Hi...the reason insurance companies differ so much is it depends on the policy written for the company you work for. I am covered )or should I say NOT covered) under my husband's BC/BS plan and they denied me based on an exlusion his company had written into the policy. It states that the treatment of obesity and weight loss conditions is exluded. NICE, huh? Now I have to go on my own insurance through my employer and put off my surgery til January. I could fight them but from what I have been reading on this site, it could take months to get a reversal. Good luck with your approval!!
   — [Anonymous]

August 24, 2001
It just varies from employer to employer. The company (BCBS) allows the employer to decide on the coverage they are willing to provide (pay for). I have BCBS Federal and I didn't have to have anything other than just my Surgeons recommendation to them that I qualified for the surgery. I had my first consult with my surgeon on a Tuesday (last April) and was approved and had a surgery date three days later. (my surgery wasn't three days later - the BCBS approval was three days later!)
   — Cathy J.

August 25, 2001
That's it exactly. It depends on what policy your employer purchased. You have to read "your policy's exclusions". That is why they are all different.
   — Jessica Hernandez

August 25, 2001
i have federal bc/bs & my approval took exactly 2 days. the only requirement they had was that i was 100+ lbs overweight.
   — sheryl titone

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