Insurance

hlpnhnds · April 1, 2007

HI all-- this has been a very informative site. I have had my initial visit with my doctor. My psy consult, fitness eval and nutrition consult have been scheduled. My BMI is just over 40. I was wonder if anyone out there had BCBS and if they had any trouble getting approved.

Thanks:)

Kat817 · April 1, 2007

Hi---welcome to LBT! I do have BCBS---it is BCBS of TX. And yes they made my life miserable!!! BUT---there are many, many different coverages of BCBS, and a lot of it depends on what exclusions your employer placed. It is impossible to advise you---the best thing you can do is call them. Take meticulous notes---when you called, who you talked to, what they say....and put on your tenny shoes, and get ready to jump through some hoops!!! The good news is...it is SOOOOO worth jumping through them!!!!

Each plan has different requirements. Mine consisted of 5 years of documented obesity, a BMI of 40 or 35 with 2 co-morbidities, and 12 consecutive months of a medically supervised weight loss program, with bi monthly nutritionist consults. My problems come in with the 12 consecutive months thing. I had done 10 1/2 months consecutively, and then was in a car accident, and required surgery. Due to that I missed my appointment in the 11th month, and rescheduled it for when I got out of the hospital...but it was over 30 days since the prior appointment, and they decided I had been non compliant. So they denied me...twice. It was a mess---I likely could have sued and won....I gave up, and self paid---with my settlement from the accident! But my SIL has BCBS, and she had no problems whatsoever! So it is a guessing game as to what your plan requires, and what clauses your employer added.

Make that call, and get the ball rolling---it is a great thing this band!!!

Good Luck!! Hang out with us---lots of people working to get approval---this site is perfect for support!

Kat

hlpnhnds · April 1, 2007

Thanks Kat-- Mine is BCBS of NC and according to my booklet all that they require is a BMI of 40. My doctor asked me to get the last 5 years of documented weight and I am worried because they are at a BMI of 32-38. I guess I just need to give them a call

Thanks

NVgirl · April 1, 2007

I have BCBS in Nevada and they couldn't have been any better! Paperwork was sent to them on a Friday and approval was given that very next Monday. 6 weeks till surgery!