Do any of you have BCBS of TN?

Thread Starter  

I was curious if any of you have BCBS of TN. I have it and Im looking into having the procedure done. Im calling about everything tomorrow to try to start the whole process. I know that my policy covers 80% of surgery, but it doesnt specify what kind of surgery. Any advice you could give me would be great!

I have it but there is a wls exclusion. So I can't use it.

Don

Thread Starter  

Thanks.. Yeah, I found out that my policy has the same exclusion so I cant use mine either.

I have BCBS of TN through my parents. Our policy including WLS but you had to prove that you had been on a doctor supervised weightloss program for 6 months and had been overweight for 5 years. I was denied the first go around because of insufficient medical documentation on the doctors part. I resubmitted as an appeal and included a personal letter that I wrote about how my weight effects my life as well as additional medical records and another strongly worded letter from my primary care physician. I don't know if my letter made the difference, but I was approved and I am having surgery May 31st. Make sure you check your policy and see if it is covered and also include as many real numbers (weights- up and down, cholestrol, blood pressure, etc. -family history) as you can. Numbers don't lie-generally. Good luck getting covered. Also BCBS pays 80% in network. If your doctor is out of network they pay 70%-still worth the fight for approval.

I am part of the Blue Cross state teachers plan. It took about six months, but they finally agreed to pay. I was told at first that I was too healthy for them to perform the surgery since I had no problems with blood pressure, blood sugar, or cholesterol.

I was about to file a grievance, but for some reason they changed their minds.

My surgery is on June 12.