Anthem BC/BS PPO

[Ladymickey25]

Hello,

Does anyone know if you have to have a one on one nutrional evaluation to be approved for WLS? When I read the medical policy critera, it does not state one on one. When I spoke to a representative she basically repeated what I read. When I spoke with another representive she stated from what she read the answer would be no. I just want to touch basis with someone who may have used Anthem BC/BS PPO and could possible let me know for sure.
Thanks In Advance

 

[Clematis]

All Anthem policies are different. It all depends on your Evidence of Coverage (aka Your Health Certificate, and/or A Guide to Your Benefits as titled on my Anthem policy) -- a 100+ page document that details your particular policy. Mine doesn't cover WLS at all so I can't even show you a paragraph as reference. I was able to order this document online for free on the homepage of the MyAnthem website. Or rather I could print out an order form which has to be signed and sent to Anthem. You may be able to do that. You can try your HR department too.

 

[Ladymickey25]

I will do that. I may just go ahead and see a nutrionist one on one just to be on the safe side. The insurance wont pay unless you are a diabetic. Thank you Clematis.

 

[Oneheadlight]

I don't know anything about your policy. I do know how frustrating it is to speak to different representatives and be told different information. I hope you find the answers you need.

 

[Spiky Bugger]

I will do that. I may just go ahead and see a nutrionist one on one just to be on the safe side. The insurance wont pay unless you are a diabetic. Thank you Clematis.

I would check...if they (insurance) are going to require a visit they are probably going to (have to) cover it. And nutritionists just can't wrap their brains around the DS...so it may be a major waste of your time and money.