Anthem BCBS

[futureformerfattie 26]

I have Anthem BCBS (which has different requirements than standard BCBS).

Current BMI is 40.5... Just barely above the threshold for approval. I'm not required to have 6 months of physician monitored diet. I have all of my paperwork to submit for approval next week.

Trouble is, my weight has teetered in the range of 35-39 BMI for the last several years. I'm at my highest weight now, at a BMI of almost 41.

Has anyone gotten rejected by Anthem because their medical records did not show a history of 40+ BMI for a long period of time?

[AnnetteT 77]

They used my current BMI to determine eligibility.

[2muchfun 8,927]

Mine was 36 but I had co-morbids. Do you have other issues like diabetes, arthritis?

[msfitn2014 248]

I was just approved today!! Bcbs anthem i waited 10days for answer bmi 40....i am band revision to sleeve

[mgolden1984 13]

I have a band And iM hoping my insurance will cover a band to sleeve revison. I have anthem BSBC's nh

[pink dahlia 2,513]

I have BCBS, they approved me 1st letter. My bmi was 40, I had sleep apnea, and high bp. Not anymore !

[karina33 23]

i have anthem bcbs they approved me very quickly..BMI is 40...

[mgolden1984 13]

Mine is 40 as well with no co morbidities

[Texasmeg 568]

Mine was under 40, but I had co-morbidities. They approved it quickly - first letter.

[mgolden1984 13]

How about approval for a revision?

[veronicamorales 4]

I have Anthem BCBS, and I got denied for a revision, they said I am allowed one bariatric surgery per lifetime. They did not pay for my Lap Band, so I dont understand. I am gonna go talk to my Dr today he is supposed to do Peer to Peer review, I need this lap band removed, it has severely eroded and I vomit daily. I cant live like this anymore. I have severe apnea as well. Wish me luck!!!

[MamaRita 65]

It's funny how the same insurance can be so different, I have bcbs of ca, when I log in it says anthem so I'm assuming I have anthem bcbs, I had to do the 6 months nutritional classes, and if I'm not successful with band, they will cover a revision in 2 years from surgery date.

[BandingBeauty 4]

I have Anthem BCBS. My problem is that my bariatric coverage has a $10,000 lifetime max. My dr said bypass and the sleeve would cost me $50,000 and up out of pocket with my $10,000 max. My only option is the band. My dr very graciously gave me the cash self pay price which is drastically lower than the insurance price. Then he will bill my insurance leaving me very little out of pocket. That's the plan anyway. We will see how it works out. Your bariatric coverage doesn't depend on anthem it depends on what restrictions your employer put on bariatric surgery when they devised your insurance plan. I have a friend who has my exact insurance with a different employer and she was covered 100% and no lifetime max.

[Leesa926 72]

I have Anthem BSBS and know it is covered, the head of HR had it done I was told and I confrmed it is covered. What I am trying to confirm is the 6 month wait. I don't mind waiting if the doctor thinks I need to but 6 months puts me past next year and then my 2015 deductible won't count (I have the high deductible plan)

Trying to see where I can find out for sure (they have not been helpful over the phone) and or if it can be waived or at least reduced.

any advice or help on this?