Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Band to Sleeve - Insurance Question BCBS NC



Recommended Posts

Hey ya'll!

I am strongly considering a band to sleeve revision. I currently have United Healthcare with a bariatric surgery exclusion. So I will need to switch over to my husband's insurance (BCBSNC) during open enrollment in October. I am pretty sure that BCBS will require a 6 month physician supervised diet prior to approval, and I am wondering if I could/should start that through my surgeon's office prior to even getting on BCBS (i.e. would it count?) I know the costs of products wouldn't be covered if I did it before getting BCBS, but I am trying to get this surgery scheduled as soon as possible.

A little bit more on me, if anyone wants to comment on this info as well:

Banded September 2012 (self pay due to no cormorbidities and under BMI 40). Lost 20 lb, mostly because of post op recovery diet. Regained and more. Spent about 1 year too tight ( I thought it was normal to vomit at every meal) so I ate "around" the band and maintained at about 225 lb. About 3 months ago, had band unfilled completely, gained 15 lb. Had a 2cc fill about 3 weeks ago and continue to gain with no restriction. Currently at 240lb (5'7"), BMI is 37.6. Next fill is in about 2 weeks and I am scheduled to talk to my surgeon about revision. I have a sleep study scheduled around the same time and I am 99% sure I now have sleep apnea. Nutritionist visit scheduled next week. I am also having mobility issues including tendinitis in my right foot/ankle whenever I try to start a walking program.

Thanks for your comments!

Meredith

Share this post


Link to post
Share on other sites

Hi, I have bcbs NC and I had to do the 6 month weight documentation prior to my surgery,but I found out that July 1st they changed the policy and there is no more 6 month wait. I'm not sure if it is for all plans but I am pretty sure it is

Share this post


Link to post
Share on other sites

To bar them from excluding something due to fine print, be safe not sorry. Just wait until you are on the plan. Will it be much longer?

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • rlcpd

      Two months out from hiatal hernia repair.  Surgeon said to expect a lot more flatulence...something about the 'air' no longer being able to 'burp' out so comes out the other end.  That is my experience but have no understanding of why that swallowed air cannot be 'burped'. ???
      · 1 reply
      1. BlondePatriotInCDA

        As I understand it since your stomach is smaller and not completely resting against your diaphragm anymore you no longer have the ability to "push" burps out as well. Plus, since its smaller and we don't digest slower the trapped air moves a lot quicker out of the stomach so its no longer available to burp out. Hence the other option for removal.

    • Lizette1122

      Anyone had the TORe procedure? How did it go? How much weight did you loose? 
      · 0 replies
      1. This update has no replies.
    • LadyVeteran1

      Sleeve surgery is on April 14th.  I am counting the days!!  Can't wait!
      · 3 replies
      1. Brookie2shoes

        Me too girl!! Are you in the full liquid diet right now? It’s sooooo hard!

      2. LadyVeteran1

        Not yet. I was told I only have to do 24 hours of a liquid diet. But I have my pre-op tomorrow so I’m going to confirm if I need to do longer.

      3. buildabetteranna

        Your so close now! It's gonna be great :) Wishing you a speedy recovery and looking forward to seeing how it goes!

    • buildabetteranna

      Down 33 lbs and slightly stalled, but I'm gonna reevaluate and push through. I started back to work last week after 2 years of being disabled due to mental health as well as my weight. It's a great job and I'm just so happy to have this opportunity at a second chance at life. Hope everyone is having their best journey ❤️ Together, we got this!
      · 2 replies
      1. DaisyChainOz

        Great work Anna! Keep it up 😁

      2. buildabetteranna

        Thank you ❤️

    • Bashbee91

      Hey guys new to the process looking forward to this new life. 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×