Highmark BS PA

[Marisa1972 3]

I have Highmark BS in Pennsylvania and was wondering if anyone could share their approval experience. I am currently around a 41 BMI. I am in month 5 of my visits and basically I have gone up and down by 1/2 lb. each month. Right now I am about 1/2 lb. down from my original weight. I have an extremely difficult time losing weight, which is why I haven chosen to go down this path. I am terrified that I will be denied if I only lose a pound or two, however, to stay at a 40 BMI, I can only lose about 8 lbs. before I drop below 40. Has anyone had a similar situation? I have been overweight my entire life, have tried to lose many many times over the years, but ultimately end up gaining it back. I am just so nervous about the whole insurance approval process. Can anyone ease my mind?

[Catherine Gray 11]

I have BCBS NJ. I Don't have any specific information for your state but I was required to do 6 months supervie diet, psych, pulmonary and gi clearance, as well as routine blood work and ekg.

Im am waitw for approval now. I have 2 insurances so im wautingvon approval through the second.

Bestb of luck!

[Blithe5678 0]

Hi Marisa,

I was just wondering if you had any updates with your insurance? I have Highmark Flex Blue PPO 1000, and just found out from the 2nd rep I spoke to that a sleeve wouldn't be covered. I was just curious what plan you have and if you found out that you are covered?

[Marisa1972 3]

I have Highmark Blue Shield PPO (with a $1000 deductible). It only took about a week for me to get approval once they submitted all of my paperwork. I was surprised that I didn't have any problems. I had my surgery on 3/31 and no problems getting the sleeve approved. I hope you can appeal and get approved!

[Blithe5678 0]

Thanks Marisa!

Were you initially approved because your plan did cover surgery?

Mine is now listed under exclusions, however I was under the impression that the way the dr would code the procedure could override it being listed a an exclusion.

Which I guess was completely wrong.