Question:
Why do some BCBS approve WLS and some not.

Mine insurance is BCBS of SC. Does it matter who the employer is. Mine is through Winn Dixie stores. It has a weight loss exclusion. Is it worth fighting for? My surgeon says I qualify for surgery. What next?    — Tina T. (posted on May 1, 2003)

May 1, 2003
Hi Tina. We've had two individuals within our support group get approval after lengthy appeals with Winn Dixie. The only company with a more difficult exclusion is WalMart. The reason some BCBS covers it and other don't is because employers choose what they want included in their policy and what they don't. It seems that it would make more sense to campaign with the powers that be at Winn Dixie. At renewal they can change the exclusions and inclusions of their policy. Good luck to you!
   — ronascott

May 1, 2003
It does matter who the employer is. They are the ones who buy the policy from BC/BS. There are cheap policies (ones that have exclusions for expensive wls) and ones that are better. It just depends on what policy your employer bought.
   — ZZ S.

May 1, 2003
It can also matter what state you live in. There are a few (FEW) states that mandate coverage for WLS, so that can also be a factor. For some reason, BC/BS seems to be a couple of hundred different companies, depending on where you live or where your employer has its main office, etc.
   — garw

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