Question:
Help....Will I have a problem getting approved? BC/BS of Tn. Blue Preferred PPO
Hi everyone....I just got my handbook today with BC/BS of Tn. PPO Blue Preferred. The only thing I have been able to find is Weight Loss Programs. It says at the top of the page....This contract does not provide benefits for the following services, supplies, or charges: Weight Loss Programs. It doesn't say anything about obesity or morbid obesity. I would think a weight loss program would be Weight Watchers or Jenny Craig. It also looks like you have to prove medical necessity. PLEASE...anyone that has this insurance email me and let me know what problems you might have had. Let me know what exclusion you have and what the denail letter said. I would like to know if I might have a chance getting approved this time. I have been fighting for surgery for a year and a half now. I want to know if I am waisting my time with trying to get approval with this insurance. Thank you for you help! — Stacy P. (posted on June 8, 2000)
June 8, 2000
I haveTN Blue Cross/shield Prefered PPO. I called the insurance Company and
got two different answers. #1)She told me they do cover the surgery if it
is medicaly ness. The second time I called, the lady said she could find
nothing on Morbid Obesity and concluded it must not be covered. Although I
read about people who have been approved on the insurance part of this
site. My doctor's office also says they will help with the insurance
company.
— Christine L.
June 9, 2000
I also have BCBS/PPO. My benefits booklet specifically stated that
treatment of obesity was an exclusion. Therefore, the initial request and
my appeal were denied. However, after consideration of all of the facts,
my employer amended their contract to include the surgery effective
6/1/2000!!! WOW! Since your contract doesn't say it is excluded, I'd go
for it!
— Toni2760
June 9, 2000
I also have BCBS/PPO. My benefits booklet specifically stated that
treatment of obesity was an exclusion. Therefore, the initial request and
my appeal were denied. However, after consideration of all of the facts,
my employer amended their contract to include the surgery effective
6/1/2000!!! WOW! Since your contract doesn't say it is excluded, I'd go
for it!
— Toni2760
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