BCBS Illinios questions HELP!!

CheriCline · November 5, 2006

Hi, I need help from someone. I am a 30 year old woman that weighs in at 275 pounds. I have battled my weight my whole life. Just recently did I cross over the 40 B.M.I., and need serious help. I have tried so many diets in the past Weight Watchers, Jenny Craig, Fit America, Slim Fast, Phentermine (prescription), counting calories, etc, etc. I have lost 30 pounds and then put it all back on and then some once I tried to eat regularly.

I have back problems now front a car accident. My doctor told me that I need back surgery, but that I should have weight loss surgery before I have back surgery. There are more risks to the back surgery since I am overweight. I have seen my primary care physician once for weight and he sent me to a nutritionist. Didn't do much good...the nutritionist just told me "what I should be eating regarding portions" I know this, but don't do it. So anyways, I have called about Lap Band surgery. I have Blue Cross Blue Shield HMO.

BCBS's website says that I have to have a five year medically documented history of morbid obesity. I don't have this in my medical history. I have always been heavy and overweight but not this heavy. It also said that I have to see my doctor for wieght loss for a 12 month period before I can qualify. Are there any ways around this? Has anyone else ever heard of needing a 5 year history of obesity that has been medically documented?

I really need this surgery to help out with my back pain. I am so young still and find myself exhausted. I don't have kids but want to be able to one day. I need help...anyone have any advice regarding getting this procedure covered and where I should start....

Thanks, Cheri:phanvan

LA chula27 · November 5, 2006

HI Cheri,

The first thing you need to do is go to your PCP and ask for a referral to go to Lapband surgeon. You might have to go to some type of meeting before they make your 1st appt. And regarding your insurance

you should just call them and find out what the requiremets are all insurances are diferent with diferent policies. In My insurance website i found out the same thing you did and but i got approved in one day!!!!so my advise will be to call them directly and find out. And if you have been over weight and have co-morbies they might not need any of the "other junk" that they require!!! Don't let this be a set back for you! Good luck to you. And i hope this helped! keep us informed.