[ageoldie]

Did everyone see the message on the 3FC home page saying BCBS in Florida is no longer going to cover Gastric By Pass surgery. They site the fact the 3% die from it and 20% have to have additional surgery, but then it hits on the REAL reason. More people are opting for this surgery and it's getting too expensive to cover it. Do you think they'll anounce they are no longer going to cover gall bladder surgery next? I know about five people who have had gallbladder surgery since the first of the year.

[Ditzy Blonde]

I think you hit the nail on the head there Barb! I was never impressed with BCBS when I had it. We always had the comment too high for our area, so we always paid out more than the 20% we were supposed to!

[jiffypop]

yeah... we all know the REAL reason. and i was wondering what the mortality is from gall bladder surgery. just haven't gotten around to researching it.

[Jennifer 3FC]

I'm butting in here ~ I'm lost, what is the relation of gallbladder surgery to gastric bypass?

[jiffypop]

sorry jennifer... it's just that we're using it as a comparison. it's a lap procedure, and it's done on the abdomen. and there IS a risk of death from it as well.

it's just so obvious that bcbs doesn't want to spend the money. it's also possible that they've forced their members into using inexperienced doctors in order to save money, and that the result has been an increased mortality rate. i have no evidence to support that statement, by the way, but a number of insurance companies are requiring that wls be performed by general surgeons rather than specialists in order to save $$$$.

[Jennifer 3FC]

Ok, thanks for explaining! Ya know, I'm not too surprised with this as popular as the surgery has become. The insurance companies do have to take in more than they spend out, or they can't operate. I think they have to cut out the $$ in the most 'optional' of surgeries. Don't get me wrong, I know this isn't an optional thing for some people!

Some insurance companies won't cover infertility issues, either. It is a very expensive route and compared by insurance purposes, not medically necessary. But tell that to the ones struggling to have a baby - .