BCBS HMO California? Does it cover WLS?

Hello!  I've been trying to have WLS for over three years and all 5 of the insurance companies I've been with during that time have a WLS exclusion.  I was wondering if anyone has had luck with Blue cross blue shield HMO of California?  That is our new insurance and will kick in on April 1.  Thanks in advance for your help~ Julie

Hi Julie, I don't have BCBS HMO of California (I am in Florida) but I recommend that you go to your company's human resources office and ask for a list of covered benefits and exclusions for your new health insurance provider.  They should have it. Just because other people may have your same health insurance doesn't mean they are going to know if WLS is excluded.  It depends on how your health insurance is funded by your employer. Good luck.

In addition to checking with your human resources department, you can contact the health insurance company as well to get information on coverage for weight-loss surgery.  Some health insurance companies provide information on their Web sites as well, so take a look at those.

I have Blue Cross HMO CaliforniaCare. I called them and they said the lap band is covered if medically necssary. I didn't ask them about gastric bypass because at the time I wasn't interested in that. They said the medical group must determine it to be medically necessary. When I looked at the list of covered benefits, it looks discouraging but it isn't exactly what it appears. It listed WLS under exceptions, however, it did say something about "unless medically necessary."  So I know it is a possibility but I haven't had my surgery consult so I haven't gotten to the approval process yet. Donna K.