School District Employees- Help

I am a Greenville School District employee currently insured thru BCBS State. It has a written exclusion policy. I could also change to Blue Choice HMO or Cigna HMO thru the district. Has anyone been approved thru either of these? Thanks for any help!

I have heard that Blue Choice covers it and I know some of the ladies on here have gotten approved through Cigna, but I am not sure which policy it is. Alot of Cigna policies require a 12 month supervised diet. Good Luck, Britt

Hi CR: I am employed with the state and am very much aware of the exclusion policy for BCBS state. For that reason I recently changed my ins. place to Bluechoice and after the first submission letter to the ins. co. I was approved. However, the surgery must be medically neccessary such as a BMI of 50 or over and/or other health problems such as HBP, HC, SA and so forth. My advice to you will be to search this website and you wil become familiar with a surgeon in your area or somewhere within the state. I am with Dr. Thomas Bryne at MUSC. Good Luck with your search. Hope I was of some help.

CONGRATULATIONS ON YOUR UPCOMING WLSurgery DATE ... ONLY ABOUT 2 WEEKS TO GO! I ADDED YOU TO OUR SC WEIGHT LOSS LIST & LOOK FORWARD TO NOTING YOUR FUTURE SUCCESSES. I HAD/HAVE DR BYRNE & THINK HE IS THE BEST ... THE STAFF ON 6 WEST WILL GIVE YOU THE BEST CARE! I COULDN'T HAVE ASKED FOR BETTER. PLEASE JOIN US ANY THURSDAY EVENING AT JC's ON ASHLEY PHOSPHATE AT OUR LCBBuddies SUPPORT GROUP MEETING. BRING YOUR SPOUSE, A FRIEND OR COME BY YOURSELF - HOWEVER YOU FEEL COMFORTABLE. WE'D ENJOY GETTING TO KNOW YOU! GOD BLESS YOU DAWN & NICK

I am a Charleston County School Distric employee. I previously had Companion as my insurance carrier. During open enrollment, I switched to MUSC Options (Blue Choice) Health Plan. My insurance was effective January 1, 2006. Shortly after the New Years, approximately January 6th or 7th, I saw my primary care doctor and told him I wanted a referral to MUSC Dr. Byrnes, for gastric bypass. He agreed and sent the referral. The day before seeing him, I called MUSC myself and received the information packet. I submitted the information packet around the 10th of January. They called and scheduled me for an appointment with Dr. Byrnes on January 26th, 2006. I had gastric bypass surgery February 24th, 2006 (9 days ago). Everything went smoothly. I had no problems at all with the insurance company, but I severe Diabetes, and Hypertension. I was apprehensive during the process, because everyone said I would be rejected and would have to appeal. I hope this information helps you and you are as successful as I was in getting your WLS surgery. Vanessa

CAN YOU GET MUSC OPTIONS, C R? I UNDERSTAND SOME STATE EMPLOYEES ARE OFFERED THIS CHOICE & THEY DO COVER WLS & ARE FAIRLY EASY TO GET APPROVED THROUGH. THE BEST THING TO DO IS TO CHECK THE "CRITERIA" FOR "MEDICALLY NECESSARY WLSurgery" WITH EACH POLICY. THAT WILL TELL YOU UNDER WHAT CONDITIONS THEY WILL APPROVE THE SURGERY & WHAT THEY WILL REQUIRE OF YOU ... LETTER OF MEDICAL NECESSITY ... PHYSICIAN SUPERVISED DIET ... CERTAIN MEDICAL & PSYCH TESTS & SO ON. IF YOU TALK TO A REPRESENTATIVE OF ANY INSURANCE COMPANY, BE SURE TO STATE, "MEDICALLY-NECESSARY WEIGHT LOSS SURGERY" ... ALWAYS USE THE WORDS "MEDICALLY NECESSARY" OTHERWISE MANY WILL SIMPLY TELL YOU THE PROCEDURE IS NOT COVERED. GOD BLESS YOU DAWN & NICK