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Nervous about BCBS NC requirements.



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I am 5'7" and 257 pounds. Being a teacher and on my feet all day my weight puts a lot of stress on my body and I have very little energy by the end of the day. I do not have any other health issues except for my weight. A few years ago I tried weight watchers and lost 35 pounds but gained back all of it plus another 50 pounds. I have tried nutritionists and several other changes to my eating habits but I am always hungry no matter what.

I have been looking into having VSG for the past few weeks. I have an appointment set up with my general practitioner and have signed up for a seminar about bariatric surgery through Rex Hospital. I contacted BCBS and they went over all the requirements. I would like to know if anyone else out there has had their surgery covered by BCBS NC. How difficult was it to go through the whole procedure of getting approved by them? I am so scared that they're going to deny me the surgery.

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I didn't have BCBS NC, I have BCBS FL but my plan didn't cover any bariatric surgery.

What I wanted to say is I'm also 5'7 and I was 260 when I decided I needed surgery so our stats are very close!

By the way, I went to Mexico. I got a loan for $4,500 and it covered everything excluding airfare.

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At your height and weight, you have a BMI of 40.2. I can't speak for BCBS of NC, or for your particular plan, but with a BMI > 40, there may be some pre-op requirements, for instance, six months in a supervised weight management program, but the "magic number" for plans that do cover weight loss surgery is a BMI of 40 or more.

Here is a link to their Centers of Excellence: http://www.bcbsnc.com/content/providers/bdc/bariatric.htm

Google "BCBS NC weight loss surgery policy" and you can download a copy of the policy. Criteria are on page 5 of the PDF.

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I am 5'7" and 257 pounds. Being a teacher and on my feet all day my weight puts a lot of stress on my body and I have very little energy by the end of the day. I do not have any other health issues except for my weight. A few years ago I tried weight watchers and lost 35 pounds but gained back all of it plus another 50 pounds. I have tried nutritionists and several other changes to my eating habits but I am always hungry no matter what.

I have been looking into having VSG for the past few weeks. I have an appointment set up with my general practitioner and have signed up for a seminar about bariatric surgery through Rex Hospital. I contacted BCBS and they went over all the requirements. I would like to know if anyone else out there has had their surgery covered by BCBS NC. How difficult was it to go through the whole procedure of getting approved by them? I am so scared that they're going to deny me the surgery.

Bcbsnc has been great, at the first appointment i had to have a bmi of over 40 and they only required a surgeon of something excellence which is easy to find. I was not required to lose weight by bcbsnc. my surgeon did require test, psy appointments, nut appointments. My information was sent to bcbsnc when i was complete and when i called to ask if they recieved the documents from my surgeons office they told me i was already approved. Good luck.

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By the way i was not required to be on a supervised diet.

By the way i was not required to be on a supervised diet. I am in Charlotte so if you are near i could give you my surgeons office info.

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I have BCBS NC and the process was extremely easy. I'm 5'4 and I was 250 when I started the process. My highest weight was around 255. The process was fast. I started April 22nd. I could've have my surgery mid to late May but I put it off until July 30th due to prior obligations and I didn't know how long it would take to recover.

Best of luck!!

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Where in Mexico?

Tijuana

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