BCBS/TX ! I am lost !

[TinaM8 9]

Just to give you a little background I had the lap band surgery 7 years ago. I have had minimal success and a lot of problems. I was a self-paid patient for the lap band but am now considering the vertical sleeve and will have to be approved through insurance because I cannot afford another surgery. I called my surgeon's office this morning and it seems as though it is up to me to find out if I am covered for bariatric surgery. Ummmm.... okay now what? I assumed that the surgeon's office would take care of all of that for me. This is all so Greek to me! What should I do?

[anniemay 150]

Call the 1-800 number on your card and they should be able to tell you if it is a covered service and what requirements are needed for it to be covered. They will need the group number and stuff off your card. Let me know what you find out

[TinaM8 9]

"Call the 1-800 number on your card"

I am about to call!!! Now if they don't speak "Greek" to me on the phone I will be doing okay!

[TinaM8 9]

Call the 1-800 number on your card and they should be able to tell you if it is a covered service and what requirements are needed for it to be covered. They will need the group number and stuff off your card. Let me know what you find out

Well I called. They said that it is covered however, it differs from case to case as to whether you get approved. Doctor will have to send all medical records and a letter and then they will decide. I am just going to get it in my head that I most likely won't be approved. Not to be a negative Nancy but because I don't have any of the obesity related problems that seem to be determininh factors. Things such as reflux, high blood pressure, sleep apnea, etc. I am still going to try but not get my hopes up.

[anniemay 150]

hang in there. Is your BMI 40 or higher? That is a normal qualifier without the other issues. I calculated my BMI at 38 and was very concerned - when I went to my first appointment, it turns out I had shrunk (apparently that happens with age) and it threw me just over the 40 mark. you never know

[TinaM8 9]

Darn it !!! I calculated my BMI and it is 36.8

[CherylA 9]

Those problems that you are having with your band could help get you approved for the sleeve. Say a prayer....sorry I can't tell you to be patient because I am waiting on my approval and I am not patient. I have called my BCBS EVERYDAY to see if they have approved lol.

[erics300 137]

My pcp (primary care physician) referred me for a consult then my insurance approved it. Then i just need to follow the pre op requirements and I'll be approved