BCBS of Tennessee PPO

[Perfect_Lady3 0]

Anyone have this insurance?? Just wondering what the approval process was like. I am in the process of gathering all required documentation and just wanted to know people's experience with them. I haven't come across many people who had this insurance.

[Pixie Dust 526]

I have BCBS of MI, PPO. Not sure exactly what you want to know but WLS is covered. If your BMI is 50 or above, you don't have to go thru the 6 month documented weight loss program. I think you may need one other co-morbidity like HBP or diabetes or something else but it's a great plan! Not sure exactly how your policy is set up but I'm only responsible for paying co-pays.

[Iniysa 157]

I have BCBS of TX, PPO. WLS is covered for me as well. Had a three month diet, three NUT visits and a Phyc visit.

[taingra 2]

I have the BCBS-TN insurance but I am just starting my Quest. I was told that I have to have a documented 10% weight loss from the highest point. I will meet with the Nut, Psych, surgeon, and do my EGD on June 3rd. This is when I will know more. Do you live in TN or work for a company based in TN?

[Nuchnuch 120]

I have it..started it in January....and my first appt with surgeon was mid January ...got with my PCP to start the 10% weight lss hey required and got all the other lbs and requirements completed, including the 10% weight loss by beginning of April...insurance paperwork sent in and returned within a week...and sleeve completed by May 15th....my surgeons office was excellent and have nothing but great things to say about BCBST

[taingra 2]

So glad to hear that you are well on your way to your goal. Can you tell me more about the other requirements you had to meet. I agree , I think BCBS-TN is great.

[Nuchnuch 120]

I had the 10% of my weight to lose, I was at a 35 BMI so I had to have 2 co-morbities, which I had covered. I had to supply documentation of 5 years of morbid obesity and a letter from both your PCP and surgeon supporting you and why you are a good candidate for surgery.

[Perfect_Lady3 0]

Thanks for your responses and I'm so glad to hearth at people have been satisfied with b BCBSTN, because I've heard otherwise. I'm not in TN, I work in DC, but my company is a TN based one, so it's been difficult because there not much in network choices here. Luckily, the hospital that is in network is good and a center of excellence. My requirements are 10% weight loss from high lest weight, BMI 40, Nut appointment, Psyh eval (must include a eating disorder inventory and MMPI personality inventory), 5 years documented weight loss. I'm 13 pounds away from my 10% and it's just frustrating because its been really hard to loose it. It's good to see others with this insurance because its taken me a while to find some ppl with it, so thanks for replying.

[Nuchnuch 120]

I was in the same boat when I started, not many people responded when I had questions. I am glad you are on your way and have started your weight loss. It will come quicker than you think....it seemed to have flown by for me.

I wish you the best of luck!

[mskoiya 10]

I have BCBS TN my paperwork was sent out today but I haven't lost any weight and its frustrating that you spend so much time money and effort and that your insurance can deny you for not losing enough BEFORE surgery! But Im crossing my fingers that it gets approved!! Good luck! :-)

[TN_Vols_MiMi 6]

I have BCBS TN but I work for the State of TN so my insurance is a little bit different. They require the 5 year documented weight along with a 6 month medically supervised diet. If BMI is less than 40, there has to be other co-morbities and you basically can't lose more than 10% of your weight in that 6 months supervised diet or you will be denied.

I was able to count a doctor visit I had with my Gyn in February, and I just completed my 5th month appt. with my primary care Dr. today. My Psych appt is next week. I have completed all the nutritional counseling and support groups that are required; however, I will continue with those as well. I have had all my pre-op tests completed that my Bariatric Dr. requires. I did have to have an upper G.I. today because one of my tests showed a small hiatal hernia and stricture in my esophagus. One more Dr. visit on July 1st and my paperwork should be almost ready to be sent in to BCBS. I can't wait!

[Perfect_Lady3 0]

Good morning! MSKOIYA-Did your requirements say that you had to loose 10% of your body weight? Mine does not require the 6 month supervised diet, but the 10% weight loss. Did you get a letter or anything g reporting why you didn't loose it, but had tried? It is really frustrating and 10% is a lot to loose prior to. Please keep us posted! Looking for good news! Also, I'm not in the stage of TN, but my company is headquartered there :/.

[Perfect_Lady3 0]

Morning TN_VOLS_MIMI! Congrats on being close to your last 6 month appt! I would much rather had to have the 6 month supervised diet, instead of having to loose the 10%...at least I would have a better time frame! Keep us posted!!!

[mskoiya 10]

They denied me.. Said that I had to lose 10% of my current or highest recorded weight and that the info my dr submitted showed that I gained weight and since I went from Bcbs of IL to BCBS of TN that I have to do a different eval with the psychologist than what I already had done... Im super frustrated!!!!

[TN_Vols_MiMi 6]

It is crazy how the same insurance company requires different criteria for different plans. Seems like it should be pretty much the same across the board. I will say this about BCBS-TN, I have not been very pleased with them this year. I have the option of choosing BCBS or Cigna at the beginning of the year. I went with BCBS last year because their rates were cheaper but coverage appeared to be the same. I am deaf and have cochlear implants. I tried to upgrade my processors this year and BCBS denied me. In 2009, Cigna upgraded them no problem. I did appeal this and BCBS told me to have my Dr. call for a peer-to-peer review with their doctor. She did this and now they agreed to upgrade my processors. Looks like they are quick to deny...but if that happens...appeal!