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Federal Blue Cross Blue Shield requirements



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I have standard Federal Blue Cross Blue Shield in Arkansas. I have met all my requirements, have BMI of 42 with co-morbities of obstructive sleep apnea and high blood pressure. Have completed all my prerequisites except I have one more weigh in on Oct. 11 to complete the required supervised weight loss. Have pre-op appointment on Sept. 30 and gastric bypass scheduled for Oct. 20. Here's my question... the insurance says must have "diagnosis of morbid obesity for a period of two years prior to surgery." The year 2013 is not a problem but I don't know if they will count 2014 since the year is not finished out. If I can have my surgery before the end of the year it will not cost me anything because we have met our family medical stop loss. I was not sick in 2012 nor was I due for any check ups (remember the insurance requirements now where you don't have to get an annual pap smear, mammogram, etc.). My surgeon's coordinator said find a late 2011. I found one in December but my BMI then was only 33.9 instead of the needed 35. In early 2011 it was even lower, but I found in 2010 the office visit to the cardiologist where I exceeded the 35 BMI and he put me on a diet and I had lost some weight so that is why it was not the needed BMI in 2012. Do you think they will still approve me? It doesn't say it has to be two consecutive years so I do have two prior years, three if they will count 2014, since 2010. My surgeon's coordinator is going to call and see, but I am on pins and needs waiting for an answer.

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Did you go to any weight loss clinics? If so go get copy of yourrecords. I visited2 different clinics trying phentermine so i went in person to get copies for as long as 2 previous they just like to see you tried losing before hand. If you dont have that maybe they will use 2014 for your records.

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