BCBS of MI

[onedaycloser 136]

Greetins to all! I love this site and find the support overwhelming, thanks to all!

Question to anyone with BCBS of MI. I am in the early stages of this and did the seminar, met with Nut for the first of 6 monthly visits but fear that the insurance company will make me jump through more hoops? Anyone have this insurance and if so, can you share your storie/experience?

I appreciate any input.

Thank you

[Fixerupper 335]

I have it. They covered my lap band years ago very easily and my revision to sleeve recently very easily as well. I think the insurance is awesome. Pm me if you want more info.

[onedaycloser 136]

Thank you SOOO much for the quick response. I am hoping this is the case really I do. I guess if I supplied WW proof, or precription weight-loss meds it would be sooner? Are you familiar with this?

My BMI is just over 40 and I really want this done!!

[Fixerupper 335]

When they covered my band they took documentation like ww. It was something like six consecutive months of weight loss attempts within one or two years of seeking , can't remember exactly. I ended up just doing six months of monthly visits with my primary care doc focused on diet changes then he wrote my recommendation. I also had to do a psych eval. For my revision the hospital did have me do additional tests but I was happy about that and it went quickly.

[onedaycloser 136]

So the 6 months that you did with your PCP do you think that would be equivalent to my 6 months with NUT that I am seeing at the Bariatric Center? I did contact WW via email to see if they can send me a record of my time spent with them however not sure they will respond?

I do appreicate your help. Is your BCBS of MI a PPO?

Hope all is going well for you?

[Fixerupper 335]

Yep I have the ppo and I think doing your six months with the nut should be just fine.

[Nesa 51]

I have BCBS I'm taking my last weight management class on Aug 15 my doctors office said they will resubmit everything to my insurance to show I have completed everything on the "to due lis." Im just curious to how long does it take for them to answer back because I have vacation scheduled in mid Sept I would love to have surgery then. I still have not mentioned anything at work. How long did it take for the insurance to contact the doctor with the second approval??

[onedaycloser 136]

Great question..looking for an answer myself. Does anyone know if BCBS of MI requires documents to be submitted before approval or do they automatically approve after doctors office calls them?

Met with the NUT for 2nd visit..4 more to go.

Hoping that is all I will have to do???

Thanks anyone:)

[Olarance75 215]

Pre auth is no longer required. Surgeons office must have all documentation. Once they have all required docs they schedule surgery and bill insurance once completed.

[Nesa 51]

Question. I finished all the requirements it took me six months. Today I called my doctors office asking for the status on my insurance ( that's sugar we were waiting for it was submitted last week) and they told me I was approved for the hospital stay but it's still pending for the sleeve, for the surgery. This has really freaked me out I'm wondering if there going to deny me now. She said once they know something they will call me back. Im tempted to call Tuesday (haha) to see if they heard anything. I'm so nervous that I'm going to be denied now. Has anyone gone through this?

[Nesa 51]

What* not sugar darn phone =)

[Olarance75 215]

I am wondering if maybe the office is still reviewing your chart to make sure all documentation is in order. My dr.s office called and told me I was approved. Two days after all my paperwork was in.

[MichiganChic 3,262]

It matters less about which insurance you have, and more about who its through and the details of the policy. Employers purchase policies that govern what is covered and to what extent. The best way to get accurate answers is to call the number on your card and get specific information about YOUR policy. Good luck!

[MetroDetroitChic 86]

It matters less about which insurance you have, and more about who its through and the details of the policy. Employers purchase policies that govern what is covered and to what extent. The best way to get accurate answers is to call the number on your card and get specific information about YOUR policy. Good luck!

...you are absolutely right. I compared plans with others during a VSG learning seminar and other BCBS MI folks had different bariatric policies all together.

I will add one more thing however: get your policy in writing. I called my insurance three different times and got three different verbal answers. Not joking. It wasn't until I had the piece of paper in my hands that I truly felt like I understood and was prepared.

[loseitsoon 157]

I have MI BCBS and I had to do the 6 months of Drs visits, I'm not sure they would count 6 months of NUTS visits, I would check on that. Was quickly approved after that.