Question:
What GEM Care's criteria to approve WLS?

I am trying to find out Blue Cross -- GEM Care's -- criteria that must be met in order to approve WLS. I contacted BX and the rep did not have an answer. I contacted GEM Care and that rep did not have an answer. I need to info ASAP to give to my PCP. Thank you.    — Tammy B. (posted on July 17, 2001)

July 17, 2001
Tammy, I did a little research for you. Go to the insurers link at the top of any page. Click on your state, California. You will get an alphabetical listing of insurance companies that members of this site have dealt with. There is only one listing under Blue Cross Gem Care. That person was approved last October. He/She was able to find a great contact person at that company who had just had the surgery herself. This person helped her with documentation requirements, etc.. That members e-mail address is listed. Maybe you could e-mail him/her your specific questions about your company and maybe even get that contact person's name. Just a suggestion, hope this helps. BTW, be patient when you start to scroll down the insurance company list. There are a lot of Blue Cross listings in California. Just be persistent and you will finally reach the one with Gem Care listed. Shelley
   — Shelley.