BCBS Fed and 2 year weight history requirement

[MeFirst 65]

@"Jane13"

I'm in Jax too . I'm getting my sleeve at St. Vincents with Dr Uchal pending insurance approval.

Who was your Surgeon and what hospital did you use?

[meltravlr 19]

Approved at the peer to peer!!! Surgery on Tuesday! OMG! Can not believe this is happening. Now I am kind of panicking!

[tdc 56]

Congratulations you will be fine. So happy for you. ????

[MeFirst 65]

Congratulations! I'm so happy for you!!!! Woohoooo

[meltravlr 19]

Thanks for the support. Will post when it's over!

[NewLife1985 45]

@@MeFirst

So I had my first surgeon appt. Everything went awesome! According to my insurance advocate everything is great! I even asked her if she thought I should switch insurances and she said there was no need... We are just going to exclude the 204 weigh in.... I even got to have my NUT appt today! So I should be doing my last appt and ready to submit Feb 10! Even my doctor promised if my insurance covers surgery, they WILL get it approved! fingers crossed! I will keep you updated!

[Nora82 11]

If your having surgery in 2016 you just need one weight from 2014 and one from 2015 that's shows your BMI over 35. Even if you had a BMI under 35 for most of the year if they can find one in the entire year that shows over 35 you're good.

[NewLife1985 45]

@@Nora82

Thanks! That's exactly what my surgeons office said!

[Leesa926 72]

@"Jane13"

I'm in Jax too . I'm getting my sleeve at St. Vincents with Dr Uchal pending insurance approval.

Who was your Surgeon and what hospital did you use?

I'm using dr. Uchal as well schedule surgery was December 9th but having issues with approval so I'm hoping the 16th!

[misswinnie 2]

I have the same insurance. I have weight history for 2013,2015 and got denied because I didn't see a dr in 2014. Don't know what to do now. ????

[MeFirst 65]

If your having surgery in 2016 you just need one weight from 2014 and one from 2015 that's shows your BMI over 35. Even if you had a BMI under 35 for most of the year if they can find one in the entire year that shows over 35 you're good.

I was just rereading through this thread. Do you think that an "obese" weigh in on 2014, 2015, and 2016 would satisfy the 2yr weight history requirement? Even if the time between weigh ins was not 24 months apart. I have a weight record for sept 2014, sept 2015, and will have one in January 2016.

**feeling hopeful

[Nora82 11]

Yes absolutely. They just look for the year, month doesn't matter. You just need one recorded weight from each year.

[MeFirst 65]

Thank you so much for the info! ????

[VDLT 244]

I also have BCBS Fed and they approved my band to sleeve revision. It was all done at once. I danced around the weight requirement as I don't think I technically met it. I had band complications after 14 years banded and regained a lot of weight during the last two years prior to my revision due to having a complete unfill, which did not resolve my issues.

I wrote a letter explaining my history and stated I had been successful with the band until my complications (gastritis, esophagitis, hiatal hernia, left shoulder pain). I wrote how the restriction from the band had helped me lose the weight and maintain it, and how I had regained without restriction. I also wrote about how my quality of life had changed when I had lost the weight etc.

If you log on to your fepblue account they will have on there a list of everything you have ever been assessed and diagnosed with. I used all those things on my letter. I was approved very quickly. It might not hurt to just put together your letter with your history and any supporting records (I attached imaging studies from my upper GI showing the gastritis etc, PCP records with a weight history, and records from a band surgeon I was seeing a couple of years prior in which he noted my complications).

Let me know if you have any questions. Tag me so I get a notification.

[MeFirst 65]

"VDLT" thank you so much for your detailed response!! Awesome!

I wish I would have gone straight from band to sleeve. Silly me, I thought I could maintain my weight on my own.