Pending approval

[mis4may 35]

Hi all,

I currently have a BMI of 41 and I'm 5'4" and no comorbidities. I have BCBS of IL and all my paper work was submitted yesterday. Now it's a matter of waiting but now I'm freaking out, what if they don't approve. Does anyone else have this insurance and has anyone had any issues with the approval?

[CC197823 42]

Good luck! I think everyone goes through the emotions you are, it was stressful when my paperwork went over as well. You will be fine!

[fit4life123 108]

I had BCBS IL and was approved! my BMI was 42 and I also had no co-morbidities. I wasn't one of the lucky ones who got their approval in 24-48 hours and had to wait like 2 weeks though.

[mis4may 35]

Haha thanks! I was just freaking out because it just happens to be that I received a call from them yesterday evening telling me that the place I work for has this wellness plan that can help me lose weight.

[naenae85 1]

I'm just starting the process with bcbsil. What requirements did you have to meet? I can't use a local hospital. I have to go two hours away to a blue certified hospital.

[mis4may 35]

I'm just starting the process with bcbsil. What requirements did you have to meet? I can't use a local hospital. I have to go two hours away to a blue certified hospital.

I had to do 6 month supervised weight loss diet with a physician, 1 visit with the nutritionist, 1 psychological evaluation, a letter from the physician saying that the operation is medically necessary and they also needed 2 years worth of medical records.

[naenae85 1]

Looks like I have a long road ahead of me. I had band surgery in 2011 through insurance with the same requirements you had. Then the band slipped and port flipped in 2012. Insurance had changed so had to pay out of pocket to have it taken out. My insurance just started covering bariatric this year.

[mis4may 35]

Oh wow! I thought about the LapBand at first since I really don't know anyone who's done the surgery and it just seemed like the less invasive, but the more I looked into it the more revisions I saw. It's a long process but time goes by fast :-) especially if you have a good support system!!

[fit4life123 108]

I'm just starting the process with bcbsil. What requirements did you have to meet? I can't use a local hospital. I have to go two hours away to a blue certified hospital.

I just had to have a psych eval, one nutrition class, I also had to go to a blue distinction center but luckily I live like 10 mins away from one.

[naenae85 1]

I had lap band in February 2011. My work insurance didn't cover it. But I wasn25 and learned my moms covered it. So she added me thankfully. Then during surgery my surgeon aimed a little high and hit my lung cavity. So I had a collapsed lung and had to stay over night. Then because the port was hitting my rib that had to be moved. Thankfully that was under insurance as I lost my parents insurance when I turned 26 in sept. In December things started going down hill with an emergency unfill. I was ver fortunate because my doctors wife was available. Then again in the spring it happened. My dr and his wife were out of town on a weekend but they were coming home that night and I met them at the hospital for an unfil. Fast forward. After a July vacation I came back in for a fill. He couldn't get the port to accept a fill. Kept hearing a metallic sound and bent the needle. He fiddled around and poked me (I gave him permission to keep trying) for at least an hour. Next week I had a swallow test and reg X-rays and the band had slipped and the port flipped. I was the first port flip he had ever had. I had to pay over 7k out of pocket to have it removed. I could have kept it but didn't want to pay to fix then pay to remove if something else happened.

I had lost 100lbs since I signed up for the first seminar. So I think that was 70 lbs with band counting the week after surgery. I was miserable and didn't realize how bad it was. Contortion tricks were used to try to get unstuck or throw up. Hanging over the end of the sofa to remove whatever plugged the whole to my stomach. It was horrible and I didn't see how bad till I had relief.

I also gained back all but 30-40 lbs. I had pneumonia that required daily outpatient treatment. All my doctors said that all the antibiotics caused such a weight gain. Been to thyroid specialist as I have all the symptoms only to be compared to a cow receiving antibiotics to gain weight. Needless To say 2012 sucked.

I just noticed in January that my insurance no longer had the big red exclusion for bariatric surgery and emailed. My company is literally 500 feet from my old hospital but since they aren't blue certified I will be going two hours away.

I wish you luck in getting your surgery. Thankfully the sleeve seems to not have the long term complications that the band has. I have submitted my paperwork to the hospital to get the first appointment. My email from bcbsil didn't list the 6 month diet so crossing my fingers.

[mis4may 35]

I had lap band in February 2011. My work insurance didn't cover it. But I wasn25 and learned my moms covered it. So she added me thankfully. Then during surgery my surgeon aimed a little high and hit my lung cavity. So I had a collapsed lung and had to stay over night. Then because the port was hitting my rib that had to be moved. Thankfully that was under insurance as I lost my parents insurance when I turned 26 in sept. In December things started going down hill with an emergency unfill. I was ver fortunate because my doctors wife was available. Then again in the spring it happened. My dr and his wife were out of town on a weekend but they were coming home that night and I met them at the hospital for an unfil. Fast forward. After a July vacation I came back in for a fill. He couldn't get the port to accept a fill. Kept hearing a metallic sound and bent the needle. He fiddled around and poked me (I gave him permission to keep trying) for at least an hour. Next week I had a swallow test and reg X-rays and the band had slipped and the port flipped. I was the first port flip he had ever had. I had to pay over 7k out of pocket to have it removed. I could have kept it but didn't want to pay to fix then pay to remove if something else happened.

I had lost 100lbs since I signed up for the first seminar. So I think that was 70 lbs with band counting the week after surgery. I was miserable and didn't realize how bad it was. Contortion tricks were used to try to get unstuck or throw up. Hanging over the end of the sofa to remove whatever plugged the whole to my stomach. It was horrible and I didn't see how bad till I had relief.

I also gained back all but 30-40 lbs. I had pneumonia that required daily outpatient treatment. All my doctors said that all the antibiotics caused such a weight gain. Been to thyroid specialist as I have all the symptoms only to be compared to a cow receiving antibiotics to gain weight. Needless To say 2012 sucked.

I just noticed in January that my insurance no longer had the big red exclusion for bariatric surgery and emailed. My company is literally 500 feet from my old hospital but since they aren't blue certified I will be going two hours away.

I wish you luck in getting your surgery. Thankfully the sleeve seems to not have the long term complications that the band has. I have submitted my paperwork to the hospital to get the first appointment. My email from bcbsil didn't list the 6 month diet so crossing my fingers.

Thanks!!

Ahh omg, I'm sorry you've been through so much!! Hopefully this time around things will go a little bit smoother for you! :-)

[mis4may 35]

So I was finally approved! Surgery is set for 4/20! Yaaaay!! ????

[AhnaLucille 57]

@mis4may I too have a BMI of 41 & no co's and my approval took a little over a week... Congrats on your date!! You are a day before me..

[deb1327 15]

Does anyone kno if Medicare covers the sleeve in ma.

[fksc78 9]

Good for you!

Edited May 3, 2015 by fksc78