Anyone here with blue shield of California? Please help.

[thxkbye 3]

I am 5 months into my 6 months of visits with my surgeon. I have been recommended for surgury from my primary and have seen a dietician and phyc which have also recommended me. I am 5'11 280 with sleep apnea in CPAP, Gerd, high blood pressure, high cholesterol, and joint pain. I had my first appointment with my primary physician in January and I've been told that would count toward my 6 months, I have since seen my surgeon 4 times and have one more appointment in June.

I am looking to find people that have went through the process in California with blue shield to ease my worrys. How was your experience? A denial would really devastate me. I am ready to move on with my life.

Thank you!

[MaryMitchell 23]

Thx-I have Blue Shield PPO and had to do the 6 month thing too. With all of your additional issues, you shouldn't have a problem with approval. Your doc's office should be very 'schooled' in what each insurance company needs for approval. You can call BS and get info on BMI minimums and other 'requirements' to give yourself piece of mind. What part of CA do you call home? I am in Southern Cal. Good luck and let me know if you have questions.

Surgery 4/9/13: HW 389 SW 367 CW 355 Goal 160 5'9".

[thxkbye 3]

I am in San Diego. My last visit on april 22nd my Doctor asked me to lose 12 pounds and put me on 2 Meal Replacement shakes a day for Breakfast and lunch. I have been sticking to it and have lost about 13 lbs already. I have lost the weight so fast I contacted my doctors office and office lady told me to just try and maintain the weight loss and not lose much more. I called BS and they told me that if during the 6 month weight loss period if I showed success with the program, that they could deny me due to diet and exercise working... I have never had an issue losing the weight, it's keeping it off. I have lost maybe 2 times my highest weight throughout my life only to gain it back and more. The BSCALIFORNIA lady was great though, just gonna try to stay where I am and not lose too much. I still have another month to go after this next consult so I could lose way too much at this rate. I Need to satisfy the surgeon and the insurance... Sigh.

[Ms_Kb718 22]

When I had my band placed in 2010, I had Carefirst BCBS (Maryland). My BMI was only 41 and the insurance coordinator for my previous surgeon told me that if I lost more than 5lbs or so during my 6-month pre-op diet, that my insurance company would probably deny me. Without saying it directly, she basically told me to fake my pre-op diet. My doctor did want me to lose 10lbs before surgery, but to avoid problems with the insurance company, he had me lose it with a liquid diet after I was approved. Good luck!