Question:
MY undestanding is that BCBS (PPO) will no longer be covering WLS.

My question is do you think I still have time before the end of the year to have the surgery ? Not covering as of Jan.1,2005. I am already in the process of doing paper work and having a sleep apnea test soon.As soon as I turn my paper work in the surgeon will be calling me for my first appt.    — Marcelina R. (posted on July 10, 2004)


July 10, 2004
I think what is happening with BCBS is that they are going to be putting restrictions on WLS, they are going to be saying that the person is going to need doctor supervised diet attempts before they will approve. This is the same thing that a lot of other insurance companies, Cigna, Aetna, United Healthcare, just to name a few are already doing. Good luck.
   — ChristineB

July 10, 2004
I to have bcbs of Florida, and there was an article in our city paper that states wls will no longer be covered as of 1/05. My doctor pushed all the bcbs people ahead so they could get have surgery quicker. I think that you should have plenty of time. Just push your doctors, pcp and psych dr to rush your case and do not be afraid to call them everyday and let them know the urgency. Also ask your surgeon if they will put you through quicker. One other thing, I worked for insurance company before, once you have a written letter from bcbs stating you have been approved lets say in December, and your surg would be in January it should not be a problem. As long as your insurance approves you before the new year I don't think it matters if your surgery is in 2005. Call the insurance and don't be afraid to ask them all this. Document everything along with the names and dates of whom you have spoken to. Good Luck. I had my surgery done by dr Sarantos in Gainesville and they pushed me through quite quickly. Also got approval over the phone within 10 min. Maybe if you have to drive a couple hours it would be worth it, if it meant no waiting list to be seen or have the surgery done. My longest part of the process was getting everything together from my pcp and psych md. Good luck to you!
   — Erin E.

July 11, 2004
I had the same concern. I was afraid that they would find a reason to "delay" because of them not covering after 1/2005. But once I got everything to them. I was approved within a week. Just bug them until they know your voice when you call lol. Trust me it work! Good luck
   — srtchick

July 11, 2004
I don't know what is up with BCBS. The were in California as part of the medi-cal program. As of July 1 st 2004 they are longer part of it. They are still doing private insurance. I really have a feeling they won't be a insurance company much longer. I would ask the dr to try and push getting you a surgery date. Some will try to help you out in that way.
   — Cameron Van Winkle




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