Frustrated

Hi All! I'm new to Obesity Help and I've been lurking for awhile but I just have to vent. I am so frustrated that it's hard not to burst out in tears. I've been researching wls since 2005 and decided it was time to get the ball rolling. I've completed a lot of the steps that Dr. Scott's office in Columbia, MO expects you to do. Now, I checked my insurace and guess what they have a weight loss exclusion. So, I'm totally bummed. I've called BCBS *BlueChoice* and they said wls is not an option for coverage because of the written exclusion policy. I'm still super bummed. I know that the company I work for is switching insurances to BCBS Anthem at the first of the year and I found this link http://www.anthem.com/medicalpolicies/noapplication/f4/s10/t2/pw_034084.pdf which got my hopes up a little bit and now I'm bummed again. I called the corporate office to find out if wls is something our company opted to select when they went with this insurance and he wasn't for sure. He directed me to call Anthem. I called Anthem and they can't give me any information regarding my policy because it's not taken effect yet. The lady I spoke with said that most "groups" don't opt to select wls because they don't want to pay the extra premiums. I don't know forsure that the new insurance won't cover the surgery but the lady said it probably doesn't look good. I called back the corporate benefits department and left them a lengthy message. I WANT TO KNOW IF THIS INSURANCE COVERS WLS or NOT. I'm so sick of not knowing. I pay $40 dollars a week and never claim anything on insurance and now that I need something it's not covered or looks like it won't be and it ****** me off. I'm so frustrated and angry right now that I feel like I could explode. I am my sister's support person and her insurance is Mercy and they aren't giving her one ounce of a problem. I think this also adds to my frustration. Does anyone know if I could just pay for private insurance and have this surgery? I've thought about marrying someone that works at the state hospital here in town just to get covered under an insurance plan that pays for this surgery. I know it sounds crazy but I feel like I don't have any other options. I just feel hopeless.

Hmmm - marrying someone - sounds like an episode of Desperate Housewifes. Which why are they so desperate anyway - they all look great. Anyway, I'm sorry that you are having a frustrating time. A lot of people have a long journey to the actual surgery date. It doesn't sound like the Anthem is a complete "No" yet, so hang in there. Even with policies that have exceptions, people have been known to get accepted. Keep plugging away with the baby steps and pray hard! Marilyn

I sat here, read your post and it immediately took me back to the period in time where I fought against BCBS myself. I'm just going to be unfront and honest with you. BCBS is not a WLS friendly company. I have never heard of anyone that has gotten them to cover it period. The only BCBS patients that I have heard of that got coverage were under BCBS plans that were NOT Missouri plans (I.E. Daimler Chrysler which has BCBS through an Illinois plan).... They just suck bigtime. I fought against them for years!... also you are not going to be able to purchase individual coverage that would cover WLS. Personal plans do not cover this. Even if you don't have any commorbids (that would cause exclusions of their own) you would most likely be declined for coverage based on weight alone. I know that this is not the news that you want to hear but I can't stand seeing someone get their hopes up falsely and then get them dashed. Your time would be better spent on researching any other job options that have WLS friendly insurance policies. On the outside hope that your BCBS policy is NOT a Missouri based plan... get ready to get all your "stuff" together to give them a run for their money. Please do let me know what you find out. Even if your employer's plan has NOT gone into effect yet they surely could tell you if their company (BCBS) even gives WLS as an option to an employer to choose if they so wish or if they exclude it completely. That way you don't waste your time dealing with them.... Hang in there kiddo and let us know what you find out! Pixielf~*