Mandated WLS benefits from insurance company?????

My husband's new health insurance will kick in on June 1st, and the coverage will be from Blue Cross and Blue Cross of Massachusetts.  I wanted to know if they cover wls or not, so I checked to see what their policy bulletin, and this is what it says:

(mandated coverate) Per Bulletin 379 insurance requires one diet consult with history of previous weight loss attempts.  Sleeve and StomaphyX are investigational and not covered.

My interpretation of this is that a rny would be approved with minimal effort.  I definitely have the prerequisites met and documentation to prove so.  I fully intend to call the insurance company after our benefits are in effect, but my question is am I reading this correctly?  This seems almost too good to be true, so it probably is. But what do you all think?  I'm hoping some of you have had similar mandated coverage and can share your experiences.

Thanks in advance!!

 Unless there is something in your STATE that mandates coverage of WLS (and I know that with Romneycare, some things ARE mandated in Mass.), there is nothing that mandates BCBS (or any insurance company) to provide WLS.  It may be "mandated" by the contract they have with your husband's company, though, since all companies who are self-insured choose what benefits they want to pay to pay to include and which ones they do not.

Lora

Lora,

I think you are right... it may be a Romneycare/state thing.  I'm checking into it more to be sure.

I always enjoy reading your posts - you are very informative.

Thanks for the response!!

I know all insurances can be different even when they are the same insurance company because it depends on the policy that the employer buys etc.
I will say this though, I had BCBS of Mass when I had RNY. I was scared that it was going to be a huge fight to get approved. My surgeon made me jump through more hoops then BCBS of Mass did!  All that was needed to qualify was my BMI and me saying what sort of weight loss attempts I had. Nothing had to be proven, it was just based off what I told them!
My surgeon submitted my info and I was approved on the same day!!!  I was all ready for it to take at least a couple of weeks and I couldnt prove anything other than my BMI. I was ready to fight for it. When I got a call in the afternoon I was like, "OMG what the heck??"
Good Luck!!!

Oh my heart is pounding out of my chest right now!!!  This is so good to hear - thank you so much!!

FYI   I was the same as you. My husband switched employers and I had BC/BS of Mass starting 9/08.  I had my first surgeon appointment scheduled the first week of September. I did NOT call the insurance company before I got on board with them. I let the surgeon's office do all of that. I jumped through all of their hoops and they submitted all of my paperwork by the beginning of December. I had surgery right after the first of the year.
 

 They do cover it. Just call them and explain that you will be a new member effective 6/1, and you need information on what is covered under your husband's health insurance plan for WLS. I know my surgeon accepts them as an insurer, so just read the fine print. 

I think a lot of insurance companies hide some of that info in all that legalese. Good luck! ;)

I'm going to make this call tomorrow - thanks!!

 I had no issues with approval from BCBS of MA. I think they're even approving sleeves now. 

Sounds like they will be good to work with - especially compared to other insurance companies.

Thanks!