Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Anyone have BSBC michigan?



Recommended Posts

I'm doing my weight management classes right now so I'm wondering how long is it going to take after I'm done with my classes to get set up. Anyone been trough this with bsbc Michigan?? Thanks!

Share this post


Link to post
Share on other sites

Hi there, I have bcbs of Mi too. Ther required six months dr. supervised diet, plus my surgeon had a few of his own. I could of had my surgery as soon as the six months were finished. Good luck - hope all oes well.

Share this post


Link to post
Share on other sites

Normally when your BMI is over 50 you don't have to do the supervised diet. It depends on how fast you want to do it and when the DR is avaible. They could do it within two weeks of your diet.

Share this post


Link to post
Share on other sites

Hi Ladies. I also have BCBS of MI because my BMI was over 50 I was approved the same day as my submittal.

Share this post


Link to post
Share on other sites

I also have BCBS Michigan and was told that because my BMI is over 50 that it basically waives the 6 month supervised weight loss program requirement. She didn't mention whether or not it waived the other pre-requisites for surgery (psych eval, etc). But said that basically after the submittal it wouldn't be very long at all for the approval, and then any day after that I could have the surgery. But seeing as I only just today went to the seminar and yesterday my PCP sent over my referral to the surgeon, I think I still have awhile until my submittal for approval would be ready to send it!

Share this post


Link to post
Share on other sites

I have Blue Cross of MI and I had to do the 6 month diet. I am also a low BMI and was approved first time submitted.

Share this post


Link to post
Share on other sites

Hi kellysouthpaw. I was required to complete a psych eval.

Share this post


Link to post
Share on other sites

Had to do 6 months documented weight loss visits with forms filled out by doc, psych evaluation and attend a orientation. I was 39 BMI with apnea, high blood pressure and pre-diabetes.

Share this post


Link to post
Share on other sites

I was just sleeved 5/6, and BCBS was wonderful. I'd suggest contacting them directly and ask for the requirements for your plan. Your surgeon's office should also be able to help you out with it. I was required to have 6 months of supervised diet as well, however my surgeon's office pointed out that BCBS will now accept Online Weight Watchers!! I had done it for over a year, and printed out my weekly weights, as well as the page that shows I paid all that time. My policy didn't give preapprovals, so it was up to the surgeon's office to make sure I met requirements before surgery. After surgery, they submitted everything for payment. They paid every penny! (I had already met my deductible) $32,000 paid without an issue.

Share this post


Link to post
Share on other sites

I was just sleeved 5/6, and BCBS was wonderful. I'd suggest contacting them directly and ask for the requirements for your plan. Your surgeon's office should also be able to help you out with it. I was required to have 6 months of supervised diet as well, however my surgeon's office pointed out that BCBS will now accept Online Weight Watchers!! I had done it for over a year, and printed out my weekly weights, as well as the page that shows I paid all that time. My policy didn't give preapprovals, so it was up to the surgeon's office to make sure I met requirements before surgery. After surgery, they submitted everything for payment. They paid every penny! (I had already met my deductible) $32,000 paid without an issue.

hi... im in the process of getting insurance through my work, they use blue cross blue shield, and am kinda curious what the process is. im new to all of this. if approved through them, how does their deductible work? what will i have to pay out of pocket? if you happen to know.

Share this post


Link to post
Share on other sites

hi... im in the process of getting insurance through my work' date=' they use blue cross blue shield, and am kinda curious what the process is. im new to all of this. if approved through them, how does their deductible work? what will i have to pay out of pocket? if you happen to know.[/quote']

Every policy is different. This is how the deductable works: I have a $1250 deductable. My policy covers nothing until I meet that, and then it pays 100%. (Mine renews Jan 1) If I go to the doctor and have tests run that cost $1500, I will be billed 1250, and bcbs will pay the rest. Some policies also have coinsurance. If I had an addtl 1000 coinsurance, I would have to pay 2250 out of pocket before bcbs pays the rest. Again, every policy is so hugely different! I would get your paperwork from work that explains it, and then call bcbs. They can explain specifics for your policy. They can also tell you if bariatric surgery is a covered benefit. (Its specifically listed as covered on mine) I hope that helps you. When you get your paperwork I can try to help translate if you would like! :)

Share this post


Link to post
Share on other sites

Every policy is different. This is how the deductable works: I have a $1250 deductable. My policy covers nothing until I meet that, and then it pays 100%. (Mine renews Jan 1) If I go to the doctor and have tests run that cost $1500, I will be billed 1250, and bcbs will pay the rest. Some policies also have coinsurance. If I had an addtl 1000 coinsurance, I would have to pay 2250 out of pocket before bcbs pays the rest. Again, every policy is so hugely different! I would get your paperwork from work that explains it, and then call bcbs. They can explain specifics for your policy. They can also tell you if bariatric surgery is a covered benefit. (Its specifically listed as covered on mine) I hope that helps you. When you get your paperwork I can try to help translate if you would like! :)

it definitely helped. thank you. im pretty sure it covers the surgery. now i just gotta figure out how long i have to wait to get it. i was told that i have to wait a year after signing up with them before theyll pay for it. not sure why. maybe cause its so expensive and they wanna make sure im gonna stick around awhile first. lol idk.

Share this post


Link to post
Share on other sites

I just switched my insurance at work Jan 1! I switched blue care network to bcbs. I even asked to make sure it was covered before I did!! Haha, I have just now been on their plan 6months.

Share this post


Link to post
Share on other sites

<p>I have BCBS of MI PPO, have to do the 6 month NUT visits, the Psych visit also. Did WW awhile ago however lost my info so I sent them an email hoping they can send me verification (not sure if this happens if it will speed up the process?), but looking forward to the new ME!!</p>

<p>Hoping that the insurance doesn't give me any troubles? BMI= 40.6</p>

Share this post


Link to post
Share on other sites

Thank you all for your comments. I still need two more weight management classes and my blood work and I'm on my way after that =).

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 1 reply
      1. NickelChip

        All I can tell you is that for me, it got easier after the first week. The hunger pains got less intense and I kind of got used to it and gave up torturing myself by thinking about food. But if you can, get anything tempting out of the house and avoid being around people who are eating. I sent my kids to my parents' house for two weeks so I wouldn't have to prepare meals I couldn't eat. After surgery, the hunger was totally gone.

    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×