Blue Cross Blue Shield of Illinois

[LadyWarren 57]

I'm curious if anyone recently got surgery with the insurance Blue Cross Blue Shield of Illinois? I'm aware a couple of years ago they required a six month medical assisted diet. But, now they no longer require the diet. What do you'll think about this? Does anyone have BCBSIL, how did the process go for you?

[Nurse_Lenora 903]

I have BCBS and so far it's gone well...make sure to go to a surgeon who has a great program and they will help you with the entire process!

I'm in Chicago and can recommend a program in the city of you are interested. They have been excellent and so helpful!!!

[Suzan4Loosin 1]

I also have BCBSIL and using a well respected hospital program. I'm waiting for my approval or not, but was told by them and a call I made ti BCBSIL that was no longer a requirement. So I'm hoping and waiting.

Please post if you find out anything different and I'll post if I get my approval

[OutsideMatchInside 10,166]

http://www.bariatricpal.com/topic/344568-approval-healthcare-exchange-plan-bcbsil/

[LadyWarren 57]

I also have BCBSIL and using a well respected hospital program. I'm waiting for my approval or not, but was told by them and a call I made ti BCBSIL that was no longer a requirement. So I'm hoping and waiting.

Please post if you find out anything different and I'll post if I get my approval

Thank you! I sure will keep you updated with my process, but I will not have my new insurance until 01/01/16. Good luck to you, and please keep me updated.

[cj76 43]

I have BCBS of Illinois & they required 1 psych eval & 3 nutrition counseling visits. They have been great when I've called. They said it could take up to 30 days for approval but, I hear their time isn't that long normally. Very pleased with them...

[LadyWarren 57]

I have BCBS of Illinois & they required 1 psych eval & 3 nutrition counseling visits. They have been great when I've called. They said it could take up to 30 days for approval but, I hear their time isn't that long normally. Very pleased with them...

Thank you:) and good luck with your approval.

[Laughkc11 107]

I have BCBS and so far it's gone well...make sure to go to a surgeon who has a great program and they will help you with the entire process!

I'm in Chicago and can recommend a program in the city of you are interested. They have been excellent and so helpful!!!

Would you mind sharing the program you have been working with? I have BCBSIL and have been wanting to attend an info session and schedule a consultation, but want to work with a program that is going to be helpful and proactive. Any info you can provide would be so appreciated!

[tina74035 7]

I have BCBS in Oklahoma. Has anyone actually got them to approve weight loss surgery? Mine has a clause that says absolutely no weight loss covered.

[Wdwgirl74 8]

I have BCBSIL PPO. My work actually has baratric surgery on their list of approved surgeries- first time u had ever seen that at any job! It was always not covered.

I had my psych eval- 1 visit. I pulmonary dr visit to see if I need sleep study and clearance and I didn't need the study thank god Cardiologist visit for clearance. And I had a couple classes in group settings at the surgeons office. One of them was 4 hours where they covered s lot of info for after surgery and got a book handout that was outer bible we are to follow.

So after I had psych clearance they sent that into my insurance and about 10 days later got official insurance approval. But I had to get clearances from other Drs before we could schedule the surgery. The cardiologist held me up because he felt I needed a stress test. So I had to do an additional test that I had to cancel cause I got sick and finally did it 2 weeks later and then the dr was out for a week before he could read it and clear me!

Each bariatric program is different in what they want u to do to get your surgery date- even though BCBSIL doesn't require like a 3 or 6 month diet prior. I originally started the process with a different hospital until I found out the baratric program there- not BCBSIL- required me to have 6 dietician appointments before surgery and I could only have 2 per month. But- before I did that- I called bcbs and found out dietician appts are not covered when billed by a hospital. And they would be billed that way cause that's where the dietitians were. There were no dietician even in my city.

So I went with another bariatric program on other side of town where I am at now. No dietician appts here! They do have a dietician and coordinator that did go over stuff with us as I mentioned above but in a group setting so they can get more people done at same time. They also have an exercise specialist to help us as well.

So I would see what other bariatric programs require that you do- if you have options to go to another program.

[robd928 13]

I'm curious if anyone recently got surgery with the insurance Blue Cross Blue Shield of Illinois? I'm aware a couple of years ago they required a six month medical assisted diet. But, now they no longer require the diet. What do you'll think about this? Does anyone have BCBSIL, how did the process go for you?

I have BCBSIL PPO and I'll give you a breakdown on how it all went.

My goto hospital has always been Rush but when I called my insurance to ask about sleeve surgery they said they would only cover 60% at Rush because they're not a "Blue Distinction" hospital.

Turned out University of Chicago hospital is so I chose to have it there.

Best decision I've made.

Their program and facility is tops.

I started the process in August and was approved in November and had surgery in December.

I met with the surgeon,psych dept and nutrionist on the first day.

BCBSIL required you to meet with a psychiatrist instead of one of their social workers so I had to go back for a quick 15 min meet.

I got clearance from my cardiologist and primary care doctor, also a letter from my primary care doc stating he recommended the surgery.

Had a 3 hour pre op class to learn about the surgery and nutrition, 2 one hour diabetic info classes

Also had to get clearance from the pulmonary doctor.

The scheduler for the bariatric dept at UofC is phenomenal at her job,answers the phone on the 2nd ring and answers email very quickly. She gets all the paperwork ready and keeps you informed as it progresses.

Once my paper was submitted to BCBSIL I had an approval in 5 days.

BCBSIL didn't require any regulated diet but the nutrionist did. I was required to lose 30 lbs before she would sign off.

2 weeks before surgery I had to attend a 3 hour class with the surgeons nurse and the nutrionist to learn about eating after surgery.

Everything went very smoothly.

The scheduler calls each dept you need to see and get as many appointments as possible for the same day so you basically bounce from appt to appt.

I couldn't have been happier with U of C Hospitals and the staff.

As for BCBSIL since it was done at a "Blue Distinction" Facility they cover 90%

I know the posts long but hope it helps.

Rob

Edited January 1, 2016 by robd928

[about face 4]

Which coverage plan do you have? Silver, gold, platinum?

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[OutsideMatchInside 10,166]

@@about face

It depends on the plan you have but my BCBSIL plan last year covered surgery at 100%. I think my PPO plan last year was silver.

The list of Blue Distinction facilities is pretty long and they are the best programs so there is no reason really to choose anything else.

[about face 4]

Perfect! Thank you . I'm looking at using Northshore so hopefully everything will work out.

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[PissiChrissi 200]

I have BCBSIL and had the surgery 4/20. Had 1 little hiccup along the way because they require the facility you have your surgery at to be a "blue standard" facility. I had no pre opp diet before their decision that I read a lot of others have to do. It only took me 2 months from my first appointment to my surgery date and that's with having to start over with a new surgeon.

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