Help!! Employer has excluded WLS..what now?

debbiev
on 5/29/03 4:58 pm - Abilene, TX
My insurance, BCBS, covers WLS, but the individual at my employment that determines benefits does not deem it "medically necessary", so therefore it is excluded from my benefits. Any help on what to do next? I've talked to him, but he is VERY ignorant about this and isn't budging. Advice, please!!!! I know others have been where I am.
ERICA H.
on 5/30/03 8:04 am - Houston, TX
It is up to your physician/surgeon to write up all of your co-morbidities and medical history and then submit to BCBS...it will be up to the rep at BCBS (most likely a qualified doctor or nurse) to look at your information to deem what is medically necessary and not some stupid person at your job to make that important decision. Sorry you had to go through that. Talk to Member Services and see what they say...do you have medical problems
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