BCBS of NC

[Displaced Va Girl 23]

Does anyone have bcbsnc? I feel like this is the hardest insurance to have bc the 6 month wait is hard and I've done nothing but gain weight. My bmi is borderline and I'm nervous. Any advice would be helpful.

[Jersrose43 837]

A lot of people on the site have 6 month supervised visits. I don't understand?

[beachgurl84 456]

I have BCBS NC platinum 500. I live in NC but I'm working in PA for the year so I'm doing my surgery in PA. I called and spoke to the prior review office, they emailed me the detailed documentation on what they cover for this surgery and what's required. I just went to my first information session last night so I'm starting at the very beginning. In the session last night, they said insurances usually look at your starting weight, so don't worry if you lose weight pre-op. Where are you in the process or have you already had your surgery?

[ncgirl77 6]

I have BCBSNC (State Health Plan)...and I have to do to the 6-month medically supervised weight loss visits, too.

I called BCBSNC yesterday and they stated that all BCBSNC policies that support bariatric surgery have went to that rule due to Medicare changing their rules (NC changed with them).

I'll most likely be going to Duke Raleigh Hospital for mine, and my surgeon said he hopes that when the plans come up for renewal on 12/31 that the policy will change back and the 6 months of visits will no longer be required. *fingers crossed*

I've actually thought of having the surgery down in Mexico due to the wait and the cost being about the same. Still considering it, actually.

[sunnkistme 76]

I too have BCBS Ca. I am in month two of my 6 month supervised diet. I am right at the edge with my BMI the Dr says I must weigh my exact same weight when I go to the nutritionist and then I will need to focus on getting where I need to be. I am worried that I will go through all of this and then be denied because my BMI is too low. Right now I do not have any typical co-morbidity other than rather debilitating arthritis.

Edited June 13, 2014 by sunnkistme

[beachgurl84 456]

For anyone else that has BCBS NC, I'm including a link to the Corporate Medical Policy. If your plan covers bariatric surgery, these are the requirements you have to meet.

http://www.bcbsnc.com/assets/services/public/pdfs/medicalpolicy/surgery_for_morbid_obesity.pdf

[Displaced Va Girl 23]

Thanks guys. Sorry I've been away with in-laws for two weeks. My 6th appt is July 3rd but the receptionist hinted to me that BCBSNC is changing their 6mth rule as of July 2014. Don't hold it against me but I thought it was worth checking into.

[beachgurl84 456]

Thanks guys. Sorry I've been away with in-laws for two weeks. My 6th appt is July 3rd but the receptionist hinted to me that BCBSNC is changing their 6mth rule as of July 2014. Don't hold it against me but I thought it was worth checking into.

Please keep us posted if they do!!! Do you know what they might be changing to?

[Displaced Va Girl 23]

Thanks guys. Sorry I've been away with in-laws for two weeks. My 6th appt is July 3rd but the receptionist hinted to me that BCBSNC is changing their 6mth rule as of July 2014. Don't hold it against me but I thought it was worth checking into.

Please keep us posted if they do!!! Do you know what they might be changing to?

Sure, will do.

[cped1973 8]

Thanks guys. Sorry I've been away with in-laws for two weeks. My 6th appt is July 3rd but the receptionist hinted to me that BCBSNC is changing their 6mth rule as of July 2014. Don't hold it against me but I thought it was worth checking into.

I have heard this as well at my doctor's office. I called bcbsnc and the lady I spoke with said she had not heard nothing about it . I am soooo hoping they change it because i will be pushing it to get it done by December. My 6 months is up in November and I will have all my deductibles met by then and all my appointments. Keeping my fingers crossed !!!

[Displaced Va Girl 23]

The 6 month wait is over. Call your insurance co. Or dr. Offices. It's over!

[juliedee 11]

I called yesterday, I am wanting to get the surgery before the end of the year. There's definitely no more 6-month supervised diet/exercise requirement! The BCBSNC rep read all the requirements for me, then I asked specifically about that, and was told it is not required anymore. YAY!

[Isabela Macedo 0]

I called yesterday, I am wanting to get the surgery before the end of the year. There's definitely no more 6-month supervised diet/exercise requirement! The BCBSNC rep read all the requirements for me, then I asked specifically about that, and was told it is not required anymore. YAY!

Hi! Starting in may I will have BCBSNC and was wondering what the process was like? How long did you have to do the diet plan if they got rid of the 6 month rule??

[beachgurl84 456]

@@Isabela Macedo

It will depend if you're on an employer health plan or private. If it's just private, see the link I posted earlier in this thread for the policy. If it's through your employer, you will have to meet their guidelines as well. I had my surgery 11/19/14 and the process was fairly easy. I met all my surgeons requirements and got approval on first letter. I was paying a ton in private insurance premiums but just counting out of pocket medical expense, my entire surgery including all the test cost $1500. Your surgeon may have their own diet plan you are required to follow.