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I had surgery on January 6th. I am 62 and have fought this fight for over 50 years.
I started by calling my insurance carrier Blue Cross/Blue Sheild of Michigan (BCBSM). I was told I should start by getting 6 months of documented weightloss attempts. I went to my PCP in April and she started the documentation.
In September, 2009 I again called BCBSM and was told that the 6 months of documentation was no longer required, just a letter from the doctor! September 1st my husband and I went to a seminar at the University of Michigan Bariatric Center. I chose U of M because my cardiologist and PCP are on staff and they utilize a wonderful system, CareWeb, so everyone has access to my medical records.
BCBSM may have relaxed their criteria, but to qualify for the surgery U of M required a physical, a psyc evaluation, 6 months of weightloss documentation, a recommendation letter from my PCP. Also, because I had a heart attack in July 2008 I needed a recommendation letter from my cardiologist and in order to get that, I had to have an ultrsound and a stress test. I had to attend at least 2 support group sessions, meet with a nutriutionist, and start a vitamin D Rx after my blood work up revealed a deficiency ...I've been told that everyone is Michigan has a vitamin D deficiency!
The request to approve my surgery was approved in 3 days.
I started by calling my insurance carrier Blue Cross/Blue Sheild of Michigan (BCBSM). I was told I should start by getting 6 months of documented weightloss attempts. I went to my PCP in April and she started the documentation.
In September, 2009 I again called BCBSM and was told that the 6 months of documentation was no longer required, just a letter from the doctor! September 1st my husband and I went to a seminar at the University of Michigan Bariatric Center. I chose U of M because my cardiologist and PCP are on staff and they utilize a wonderful system, CareWeb, so everyone has access to my medical records.
BCBSM may have relaxed their criteria, but to qualify for the surgery U of M required a physical, a psyc evaluation, 6 months of weightloss documentation, a recommendation letter from my PCP. Also, because I had a heart attack in July 2008 I needed a recommendation letter from my cardiologist and in order to get that, I had to have an ultrsound and a stress test. I had to attend at least 2 support group sessions, meet with a nutriutionist, and start a vitamin D Rx after my blood work up revealed a deficiency ...I've been told that everyone is Michigan has a vitamin D deficiency!
The request to approve my surgery was approved in 3 days.
Age: 77
Height: 5 feet 7 inches
Starting Weight: 247 lbs
Weight on Day of Surgery:
Current Weight: 227 lbs
Goal Weight: 145 lbs
Weight Lost: 20 lbs
BMI: 35.5
Surgery: LAP-BAND
Surgery Status: Post Surgery
First Dr. Visit: 09/12/2009
Surgery Date: 01/07/2010
Hospital Stay: Outpatient
Surgery Funding: Insurance
Insurance Outcome: 1st Letter Approval
Nancy6015's Bariatric Surgeon
Ann Arbor, Michigan 48109