Horizon Bcbs Nj

[kiwi0615 0]

Submitting to my insurance this week. I've jumped through the hoops of the psych eval and such. My BMI is 36 with 2-3 co-moribities. I have documented that I did weight watchers for 5 months in 2010, but I have not had a BMI over 35 for the past 5 years. Should I even bother getting my hopes up? My GI, OBGYN, Chiropractor, and Pulmonologist all wrote letters of recommendation. Need some advice...

[2bsmallagain 156]

My BCBS of Alabama would not take weight watchers. They said it had to be a doctor monitored weight loss and it had to be in my medical records in the last 6 months. They said letters would not help. They also said my BMI had to be over 40. They are so picky who knows what they will do. I am going to Mexico instead.

[Mews 37]

I have Horizon BCBS and they just required a one year weight loss attempt summary, psych eval, nut eval, and pre-surgery education class. Got approved in a few days after all of that was done. Who is your surgeon?

[adrimc26 7]

Hi there I got approved by bcbsnj but my bmi was 43. I haven't gotten the bill yet and that's what's scary. They told me I have to cover the 10% of my surgery just the hospital itself it's around 37K can you imagine. So do the math. it's crazy

[kiwi0615 0]

I have Horizon BCBS and they just required a one year weight loss attempt summary, psych eval, nut eval, and pre-surgery education class. Got approved in a few days after all of that was done. Who is your surgeon?

Noyan... I just had to push back my surgery until the end of June.. I got into a schooling program and have to wait til then. The doc's office said they were going to submit it in the week that just past.. I havent heard anything yet.. I went for the psych eval, and pre-surg class too.... getting nervous...

[Kat Crowder 34]

Interesting thread - I looked up the BCBSNJ medical policy and it said the sleeve was only for BMI > 50, but if adrimc26 got approved with a BMI of 43, it looks like they're making exceptions.