Diamond-n-the-rough 0 Posted January 8, 2011 I was wondering for those of you who have BCBS insurance if you had to get the Gastroscope to check for Gastritis? And if so did you have to have the condition for BCBS to accept you? My doctor made it sound like my insurance company which is BCBS of IL requires you to have the condition before they will pay sounded a little weird to me... Share this post Link to post Share on other sites
TexasT 99 Posted January 8, 2011 I have BCBS of Alabama and they don't cover any type of WLS. I was self-pay so I didn't have to do that procedure. Each BCBS group is different. Share this post Link to post Share on other sites
ThatDudesMom 13 Posted January 8, 2011 I was wondering for those of you who have BCBS insurance if you had to get the Gastroscope to check for Gastritis? And if so did you have to have the condition for BCBS to accept you? My doctor made it sound like my insurance company which is BCBS of IL requires you to have the condition before they will pay sounded a little weird to me... No help here....I have BCBS, but it is basically the only insurance in Kansas that doesn't cover ANYTHING related to weight loss. I hope all goes well for you! Share this post Link to post Share on other sites
hopeandfaith 6 Posted January 8, 2011 I have BCBS of OKLA and they didn't require that. I only had to go to a weight management doctor for three months. They just started covering the sleeve! I'm getting sleeved on TUESDAY January 11th!!!! Share this post Link to post Share on other sites
Susanne 32 Posted January 9, 2011 BCBS of MI does not require this Share this post Link to post Share on other sites
FlyGirl 18 Posted January 9, 2011 BCBS of GA didn't require that. I had to be over 40 bmi or 35 bmi with two morbitities like high bp, cholesterol, sleep apnea, etc. Good luck, I hope you get approved! Share this post Link to post Share on other sites
myrori 55 Posted January 9, 2011 I have Blue Cross Blue Shield Il and they required a BMI of 35 and a co morbidity. I did not have to have a scope. Share this post Link to post Share on other sites
KabinKitty 11 Posted January 9, 2011 I have BC/BS of Ohio which just started to cover the sleeve in Nov of 2010. I just got approved last week and I'm scheduled for surgery on Feb 2, 2011. Like someone else said, different surgeon's require different tests. My surgeon requires all his weight loss patients to have an upper GI. Some others don't, but do require an endescope. I truly believe that BC/BS is going to cover the sleeve in every state some day. Some company administrators put in exclusion (which they have the right to do) to exclude coverage for any WLS. I feel so blessed that my groups administrators didn't do that....yet! That is the reason I feel I HAVE to get the surgery now, before it get excluded. Best wishes to you on your surgery! Share this post Link to post Share on other sites
HollyW 5 Posted January 9, 2011 I have BCBS of IL and I had to do 3 months of dieting with my PCP, nutrionist visit, Psych evaluation was required through my insurance. My surgeon wanted the sleep study and EGD. My insurance covered everything without question. Of course even though we have the same insurance, all policies are written differently. Share this post Link to post Share on other sites
Kya 0 Posted January 9, 2011 I was wondering for those of you who have BCBS insurance if you had to get the Gastroscope to check for Gastritis? And if so did you have to have the condition for BCBS to accept you? My doctor made it sound like my insurance company which is BCBS of IL requires you to have the condition before they will pay sounded a little weird to me... I have BCBS of Illinois, but I wasn't told that was part of a requirement for insurance. Wierd. Share this post Link to post Share on other sites
BrittanyAnn1 2 Posted January 9, 2011 I was wondering for those of you who have BCBS insurance if you had to get the Gastroscope to check for Gastritis? And if so did you have to have the condition for BCBS to accept you? My doctor made it sound like my insurance company which is BCBS of IL requires you to have the condition before they will pay sounded a little weird to me... I can assure you for BCBS of IL you do not have to have that procedure done. I have BCBS IL and I work for them!!! I am sure it is something that your doctor wants you to do to be on the safe side. My doctor required a whole slew of things and BCBS paid for it all with no questions. If you need any help with your insurance questions feel free to contact me. Brittany 1 CrissyRing77 reacted to this Share this post Link to post Share on other sites
NikkiRose 0 Posted January 9, 2011 Hi, I have BCBS of Michigan and no I didn't have to have any pre-condition. My surgeon's office made it sound like they didn't even need "pre-approval"...just needed to confirm that the procedure was covered and that I had dont everything required. They must have been right because my surgery date was set rather quickly. Good luck!!! I was wondering for those of you who have BCBS insurance if you had to get the Gastroscope to check for Gastritis? And if so did you have to have the condition for BCBS to accept you? My doctor made it sound like my insurance company which is BCBS of IL requires you to have the condition before they will pay sounded a little weird to me... Share this post Link to post Share on other sites
Susanne 32 Posted January 9, 2011 BCBSMI does not do pre-approval, they won't give you anything written that they'll cover it. I am in Grand Rapids, where are you? Share this post Link to post Share on other sites
Brother J 11 Posted January 9, 2011 My BCBS did not pay for WLS. It could be the type of plan I purchased. You'd think paying about $9600 a year for insurance, it would include WLS. Share this post Link to post Share on other sites
gotamakeachange 7 Posted January 10, 2011 I have BCBS of MI PPO, they started covering the sleeve on November 1, 2010 and I was approved on November 8, 2010 within 24 hrs of my paperwork being submitted. No I did have to do a gastroscope, but I also didn't have a supervised diet. The insurance coverage is different state to state and job to job. Good Luck Share this post Link to post Share on other sites
