*slim*

Hi. First, I so understand about the out of state insurance. I live and work in TN, but my insurance is BCBS of Illinois. :confused2: To answer your insurance question, it really depends on who provides your insurance (your employer). My employer is a self pay through BCBS so my employer actually determines what is covered and how. If the provider of your insurance does cover it, they still will determine what the qualifications are. The standard qualifications seem to be a BMI of 35-40 with comorbidities (i.e. sleep apnea, hypertension,etc) or BMI over 40 with no comorbidities. Also there is sometimes a supervised diet plan usually through a doctor or sometimes even Weight Watchers is accepted. Then lastly a history of obesity (just doctor's visits showing your weight that can be calculated into your BMI). I hope this helps.

I would call that surgeons office and ask if that doctor is covered either with full benifits or out-of-network benefits on your insurance plan. Some surgeons will accept the out-of-network benefits as full pay. Otherwise, I would check into the 4 clinics that are listed under your insurance plan. I have BCBS of Illinois (I live in TN) and I was able to go on their website and find my surgeon's name even though I couldn't find his clinic's name listed. I hope this helps. Good luck on your journey!

Way to go! There are some really nice people on here that can answer just about any question that you might have. If you read through some of the threads, you will find the answer to some of your questions before you even think to ask it. Good luck to you!

Way to go! :thumbup:

Joint pain was one of the things that my surgeon's office asked about. I think it does count. If its documented in any of your medical records, you could be able to use that. Good luck with your insurance!

I would contact the insurance company myself to ask what their requirements are. Sometines, the requirements are controlled by the company (employer) providing the insurance. It can't hurt to check. Good luck!

I have told my husband (wish I hadn't:mellow:), my mom (really wish I hadn't:angry:), one friend, and my boss (who is also a friend). I have told 2 too many people.:thumbup:

My surgery is 10/02/08! Can I be a smashing pumkin too?

We could be twins, reborn on the same day!:thumbup:

I think just about everyone goes through what you are going through prior to surgery. I know I am going through it right now. I have been eating like there is no tomorrow since my paperwork was turned in. It took reading another post on here that finally made me stop. I don't want to wake up from surgery to find out that I didn't get my band because of my liver. You are strong (you survived everything else to get here). You are almost there! Good Luck to you!:cursing:

Woohoo, I am going to be an October bandster!:cursing: Good luck to us all!

Hi everyone. I am an AT&T(formerly BellSouth) employee in TN. We have BCBSIL PPO. This is the first year that lap band has been offered as WLS. Previously we were only offered gastric bypass (under BCBSAL). I had to have 5 year history or obesity, co-morbidities(sp?), and a 6 month supervised diet plan. It only took 6 days from the time my paperwork was submitted to get it approved. It's funny that we all work for the same company but have such different insurance policies and coverages. Good luck to all of you!

I got my surgery date! Yes, 10/02/08!:w00t:

I called everyday. I think they finally got tired of hearing from me. I got my surgery date today! Good luck to you too. I hope you hear something soon!

Yay for you!:tt1:

I have read so many different opinions on this one. My surgeon requires a 2 week liquid only diet prior to surgery to shrink the liver. Of course, I have been chowing down with a vengence waiting on approval from insurance. I guess it is time to wind down my out of control eating. I hope this helps somewhat.

My process was opposite also. I went to a seminar (required before I could make an appointment with the surgeon) and consult first. Then after the consult, the insurance person at the surgeon's office gathered the information about what was going to be required from my insurance before they would approve (6 month diet, 5 year history of obesity, psychiatric evaluation, nutrition visit, etc) to be sent in for predetermination. I just got word that I am approved today:biggrin2:, but I have been in the process since 07/08/08.

That seems to depend on your surgeon. My surgeon said no more soda ever, but I read where other people's surgeons said none the first year. I was told no soda because the carbination can stretch the pouch. I would follow whatever your surgeon says.

I had 6 visits over a 6 month period back in 2006 that we just happened to discuss my weight. My pcp used that information for my weightloss visits since I did actually lose weight during that time and we did actually discuss my weight. It wasn't exactly a month between each visit, just 1 visit somewhere during the month. I hope that you get a quick appoval too!:biggrin2:

I got approved thru BCBS of Illinois!!!:smile2::thumbup: No denials! No appeals! Yes! WooHoo! I am so doing a happy dance !

I got approved!!!!!!!:smile2::thumbup::thumbup:

Way to go!:smile2:

I love that! Would you be terribly upset if I "borrow" that design?

Congrats! I will keep you and everyone else having their surgery tomorrow in my thoughts! You will do so awesome!

You are right about that price! That is much cheaper than what I have seen elsewhere.