Approved by BCBS of TX TRS ACTIVECARE

Mert · July 13, 2006

I had given up and was making plans and had a surgery date in Mexico today when RRRIIINNGGG It was BCBS calling to say I am approved !!! Right here in Houston ...no self pay...no robbing the 403B acct. I am approved in Houston GOD IS SOOOO GOOD.

Mvpo8961 · July 13, 2006

Congrats on your approval. Did you have any idea of surgery date? The time will fly by.

Myra

Mert · July 13, 2006

I have an appt. with my surgeon for the first time on the 18. I will take the approval letter w/ me and see what he says. I'm sure he'll want to run some tests on me.

Poodles · July 18, 2006

Mert: I have a funny story about BCBS TRS Activecare.

I am switching school districts and wanted to make sure there would be no lapse in coverage. I called BCBS and spoke to a woman about it. When I told her why (because of my followup/fills) she started asking me a ton of questions. (And I told her about this site). She is in the middle of her 12 month supervised diet right now. I thought, how weird, they do this junk to their own people too.

Good luck getting your surgery date. I hope you can get it in before summer is over!!!!

Mert · July 18, 2006

Poodles,

That is a good one!

I'm driving in to Houston today to see the surgeon!!

woo hoo

:nervous very nervous....

StephanieH · September 22, 2006

Hello, Congratulations on your approval!

I also have BCBS TRS ActiveCare II . My Husband is a teacher and coach in the Houston area. I am just beginning the process and I was wondering about your experience. What documentation did they require?

Thanks!!

Stephanie

Mert · September 23, 2006

Stephanie,

They require a list of things, among which are:

*12 month medically supervised weight loss attempt

*comorbidities

*documentation of 5 years of morbid obesity

*psych evaluation

*letter rec. the surgery from your doctor

*and so forth...

Call the customer service at bcbs and ask them. They'll mail you the list.

They waived the 12 month medically supervised diet for me...why? I have

no idea. I was just so happy to be approved I didn't even dare ask.

Write a letter about your health and send as much documentaion to them as you can gather from your doctors about weight related problems. send me a pm if you need some more info. best of luck to you!

StephanieH · September 26, 2006

Mert,

Thanks for the information. I don't know how to send a pm, but I was also wondering... How long did it take you to get approved? From the First appointment to the approval date?

Also, How are you feeling? Did you have your first fill yet. Have you noticed a difference in your appetite?

Thanks!!

Stephanie

Mert · September 26, 2006

Stephanie,

After you log on to this web site look under the WELCOME at the top right and there you'll see private messages (in blue underlined.) Click on that and see if it takes you there.

I first heard about the band in May of '06. I knew it was what I had been waiting for so I dove into it- researching and trying to get approved by my insurance. I have summers off so I devoted the summer to it. I lost several weeks by going with the wrong doctor and waiting for their office to do something. Don't do that! Meanwhile I was gathering my own medical records from the endocrinologist, internal specialist, gynecologist and general practioner. I wrote a letter to BCBS and supported my statements with reference to the medical records. I found a human being to talk to at BCBS and spoke to her each time. She was nice and helpful. BCBS offers a service (LifeMasters 1 866 341 1167) where an RN calls you at home once every two weeks to ask you how you're doing and etc. I told her all about my Quest to get the lap band. They say that LifeMaster doesn't share what you say with BCBS, however it was not long after talking to them and writing the letters, faxing the medical records, praying to God, fulfilling the requirements for surgery and finding a good surgeon that I was called by the nice lady at BCBS and I was approved. Wham-o it came out of the blue and I had all but given up. That all happened between May and July of this year. Like I said though, I was working on it full time. the surgery took place on August 11 (last month). I had my first fill yesterday. I have not lost much. I have a big band, 10cc VG, and slow loss is to be expected. Read all about it here and gather your medical records. It will all come about in time. It is very hard to wait, though, once you've made up your mind, isn't it? I feel fine.