I have Blue Choice of SC and got denied!!!

Rebechuds · 05-06-2008, 09:01 PM

Well over two weeks (04/2/08) ago I went to my PCP and got the referrel to the Dr. Givens. I went to the Seminar on Monday (05/05/08) and also got lucky and had my first consult with them also that afternoon. While I was sitting in the office I got the bad new,

my insurance wont cover anything dealing with weight loss surgery and I don't have $14,000.00 to pay for this surgery. So now I have to appeal to the insurance to prove this is a medical need and not to just look good but for my health. I'm also needing to send a letter to our senator of SC and to the governor of SC. The state of SC has it where the insurance wont pay for this wonderful surgery. I have BlueChoice of South Carolina. If anyone has them or can help me in getting them to approve this surgery I would appricate it. You can email me on here or at rebechuds@aol.com .

I want to be here for my children to see them grow up and be healthy for the rest of my life. I have for the last month cut back alot in what I eat and have lost 6 pounds but I'm hungry all the time to. HELP HELP!!!!!
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lkgrubb · 05-06-2008, 09:55 PM

First let me tell you I was denied by BCBS of MN. What I was told was I needed to work with my primary to loose weight for 12 months. I then was told that when I went on Medicare I could apply after 6 months, and if they okayed it then I could have it done.
Long story short, if you have co morbidities: diabetes, heart problems, lung problems, joint problems, high blood pressure and your primary will write to BCBS this might help your case.
Just keep bugging the bcbs office to ask them in what cases this has been allowed.
Good luck

Rebechuds · 05-07-2008, 08:51 PM

I have spoke with BCBS of SC and they have told me that I will need to speak with my HR dept. b/c they are the ones how has put it has an exclusion in our policies for SC. I'm going a head and submitting an appeal letter with my diet history, family history and some pics of me. I'm trying to get my PCP to write a letter to them and when I go to the phsyc evel. appt in a few weeks I want to make sure I have everything so when i do get the denial, I will submit it right back to them b/c I'm ready to fight with them about this I need to lose the weight for my health.

lkgrubb · 05-08-2008, 12:38 AM

You Go Girl, We Are All Behind You And I For One Would Write A Letter For You To Bcbs As To How It Has Made A Difference In My Life In Just 3 Months!

ksandez · 05-20-2008, 07:04 PM

I have a question does anyone know if BCBS of TX PPO (Blue Choice) covers the LAP-BAND^® procedure?????