Bcbs...is It True?

[ilikebunnies 48]

So I am almost finished with my third month of pre-op diet. I called BCBS today to find out about the nitty gritty of the coverage requirements so I am ready when my consultation comes around. The rep tells me that this year the requirements changed and you don't need the 6 month pre-op diet any more. Does anyone else know if this is true? I don't want to get too excited to find out later that she was wrong.

[shuckybucky 107]

It is possible. They have made a lot of changes. Ask them for the policy change in writing or just ask your surgeon.

[2muchfun 8,927]

Yeah, I went through the 6 months of BS and jumped through the hoops to find out they had changed the rules. Oh well, banded and sort of happy.

[twelch 0]

I started process with BCBS last January and had surgery in May...I had to lose like 10% of my weight, not 6 months wait...

[Hopeful to be full 11]

BCBS is a company name but there are hundreds of divisions of the company in each state. you need to look online or call a rep to see what particular requirements are for your division. For example I live in PA and had BCBS but it was BCBS or Northeastern PA (Northeastern PA being the division). You can't just ask someone else with BCBS what the requirements are, each division is different, u need to know about yours.

[NWgirl 574]

Usually you can see the most current benefit book online and it should have the bariatrics policy in writing. I recommend looking into that to see what you need to do.

[Bel12 13]

I have bcbs-il and there is only one requirement. If your bmi is under 40 you need a comorbidity. Mine is above 40 so I just need a note from my doc saying that. My surgeon requires a 1 week liquid diet and a chat with a psychologist which I already do. He said it will take 2-3 months until I'm banded

[2muchfun 8,927]

Steph and Hopeful are both right on. If you haven't set up your online account with your BCBS affilliate, do so. Then this will no longer be a mystery and you won't have to rely on strangers for this kind of advice.

[ilikebunnies 48]

Yeah, I went through the 6 months of BS and jumped through the hoops to find out they had changed the rules. Oh well, banded and sort of happy.

Sort of? Why sort of?

[ilikebunnies 48]

I have bcbs-il and there is only one requirement. If your bmi is under 40 you need a comorbidity. Mine is above 40 so I just need a note from my doc saying that. My surgeon requires a 1 week liquid diet and a chat with a psychologist which I already do. He said it will take 2-3 months until I'm banded

Nice hopefully mine will go as smooth!

[ilikebunnies 48]

I found the policy on-line (I have BCBS of Texas) and it says what the rep did, no six month diet any more!

[ilikebunnies 48]

BCBS is a company name but there are hundreds of divisions of the company in each state. you need to look online or call a rep to see what particular requirements are for your division. For example I live in PA and had BCBS but it was BCBS or Northeastern PA (Northeastern PA being the division). You can't just ask someone else with BCBS what the requirements are, each division is different, u need to know about yours.

The BCBS rep is the one that initially told me

[2muchfun 8,927]

I like bunnies,

I'm due for fill #6. Not enough restriction so far. The lapband is helping but not doing what I had hoped it would do. I haven't given up and still think it can help me lose but so far it's not what I had hoped for.

tmf

[ilikebunnies 48]

I like bunnies,

I'm due for fill #6. Not enough restriction so far. The lapband is helping but not doing what I had hoped it would do. I haven't given up and still think it can help me lose but so far it's not what I had hoped for.

tmf

Keep at it I am sure you will hit the green zone I am thinking of having plication with my band because I am afraid I will struggle losing the weight otherwise.

[Sunshyne068 97]

Does BCBS cover plication? I have Fed BCBS and its not covered (or it wasnt covered 6 months ago)