Question:
I would like anyone that wants to share there story, good or bad!!

I was hoping to get some letters together to send to my state senator so that I can try and get insurance companies mandated to cover wls. My insurance will not pay, as it is an exclusion. I have made contacts with some state reps and I am trying to get info together to get these state officials educated. If you would like to help, either by email or by postal mail let me know. [email protected]    — Jennifer N. (posted on December 29, 1999)

November 9, 2001
I have BCBS federal PPO and was told by several doctors that it's wonderful but my doc and one other surgery center refuse to use it. Why? because BCBS refuses to give a pre-determination. They will pre-certify the hospital stay BUT and this is a HUGE one, they will only approve/disapprove the surgery AFTER the fact. That means if they later determine it is not necessary then the doctor and that pre-certified hospital will NOT be paid. I got this from their customer service. Their written requirements are 100 lbs overweight and you must be 18+, now here's the kicker...they also have to decide if it was "medically necessary." What is the criteria for this? They won't say! It's a case by case issue and some doctors will take the gamble but many won't. I was singing this insurance company's praises to the high heavens until I found out the truth. It's like a mean little carrot dangled in front of you but just out of reach. Their requirements for this surgery (100 lbs overweight and 18 years old) apparently isn't enough. Anyway, my doctor refuses this insurance because BCBS refuses to approve before the surgery. There is NO reason whatsoever for them to refuse to approve before hand. I think it's very slimey of them and I am changing insurance companies. I guess you can tell I am not happy about this. :(
   — Carmen K.