*help* Bcbs Federal Questions

[BJGOODY 0]

Hello all!!

I am new to this so bare with me. I have bcbs Fed and wanted to know if anyone has had a hard time getting approved? I know their requirements and my BMI is right at 40/41 with no comorbidities. I also noticed that they require proof of morbid obesity for at least 2 years. Being that my BMI is at 40/41 and my weight fluctuates, my recorded weight is lower and at a lower BMI. Will this effect my approval? I am scared that I will go through the process and get denied at the end. Just ready to be at a healthy weight

[SleeveandRNYchica 1,155]

I have BCBS Federal too. I hear overall the BCBS is more liberal overall with their approvals. I have spoken to them twice and they want to make sure we are following their requirements. Of course if you call they cannot reassure you, however, if you submit your records and you doctor can vouch that this surgury is necessary, I can not see them harping on the fact ur bmi may have fallen to 39.....good luck.

[MamaMelly 97]

I also have bcbs federal. My bmi has dropped below 40, but I also have comorbidities. I was approved very quickly, in 7 business days. They say you will get a decision within 10, so they are very quick. If they do deny you, appeal appeal appeal!

[smithpy 117]

I got approved with BCBS Federal. They did go back and look at my BMI for the last two years, but they did not look at every single appointment. The doctor submitted the highest weight from each year. Hope that helps.

[BJGOODY 0]

Thanks guys.. I had a baby last year and I always lose weight right before, during and right after pregnancy but the weight comes right back in a few months. So that is why my recorded weight and BMI is low for last year. So I'm really nervous about approval on that!

[kimmyiet 40]

Hi! I have Federal BCBS and that was also my major concern being denied. I do have a co-morbidity (high blood pressure) and my starting BMI was 40.1 but has since went down with losing some weight during the 3mos nutritionist visits. My coordinator stated to me that she wouldn’t submit my paperwork for approval until she made sure all I’s were dotted and T’s were crossed. I was approved very quickly! Paperwork submitted on June 25^th and approved on June 29^th.

[BJGOODY 0]

Thanks Kimmyiet...so is it safe to say that it is ok to go below a BMI of 40 during the 3 month nutritional visits? The only difference is your co morbidity. I definitely don't want to get denied because I did get under 40!

[smithpy 117]

I was told it was OK, but that you may not want to go WAY below.

[kimmyiet 40]

Just like smithpy stated “it is okay to go below but not way below”. It's more like they want to see that you've tried to lose the weight under the supervision of a nutritionist. I only lost 12lbs in 3mos.. smh.. I really was trying but I have a love, hate relationship with anything that is made of chocolate.. I just couldn't seem to give him up during that time... LOL You will do just fine and get your approval..

[BJGOODY 0]

Lol thanks again. I too have a complicated relationship with this thing called ice cream. Butter pecan is his name! I will just go into this with a positive attitude. Hopefully I will be doing the "happy approved" dance in a few months!