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?

[2goldengirl 2,076]

http://www.bcbsil.com/provider/standards/medical_policy.html

Here is the link for the current policy with criteria for bariatric surgery. Good luck!

[OutsideMatchInside 10,166]

I have BCBSIL and it took 8 weeks from first visit with the Surgeon to Surgery.

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

[LadyWarren 57]

http://www.bcbsil.com/provider/standards/medical_policy.html

Here is the link for the current policy with criteria for bariatric surgery. Good luck!

Yep.. that's the information my insurance provider gave me. Thanks;)

I have BCBSIL and it took 8 weeks from first visit with the Surgeon to Surgery.

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

Hey I appreciate the information:)

[TagUrIt 17]

I have BCBS Illinois-PPO. I saw the surgeon Sept. 17th; paperwork filed Nov. 5th, My paperwork was misfiled with the incorrect group per BCBS. I called and requested that my pre-authorization be escalated for due to their error and possible postponement of my procedure. They returned my call within 10 minutes with approval this AM! Just awaiting scheduler. Just make certain that the office provided you with a fax confirmation, date, and time. That is how my 'misfiled' paperwork was located

[LadyWarren 57]

I have BCBS Illinois-PPO. I saw the surgeon Sept. 17th; paperwork filed Nov. 5th, My paperwork was misfiled with the incorrect group per BCBS. I called and requested that my pre-authorization be escalated for due to their error and possible postponement of my procedure. They returned my call within 10 minutes with approval this AM! Just awaiting scheduler. Just make certain that the office provided you with a fax confirmation, date, and time. That is how my 'misfiled' paperwork was located

Yayyy.. Congratulations on your approval and thank you for the info

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[TagUrIt 17]

Thank you! Good luck to you as well. Please reach out if you have any questions about navigating with BCBS-Illinois.

[MrsRP 36]

I have BCBSIL and I saw my surgeon last week. They need me to do an at home sleep study since I haven't been diagnosed with sleep apnea but I do have it.

Will I have to wait too for 6 months of nutrition before I can get approval?

[TagUrIt 17]

BCBS IL has three requirements: the BMI, nutrition/fitness assessment, and psyche eval. My surgeon's office filed once those three were met and I still had other studies pending specific to the surgeon (bone density scan, stress test, etc.) I was approved before the others were completed. BCBS IL does not have a 6 month nutrition or medically supervised requirement. Hope that helps.

[MrsRP 36]

Thank you. It does. I hope to hear from them soon.

Thank you so much!!!

[LadyWarren 57]

I have BCBSIL and I saw my surgeon last week. They need me to do an at home sleep study since I haven't been diagnosed with sleep apnea but I do have it.

Will I have to wait too for 6 months of nutrition before I can get approval?

BCBSIL no longer requires the six month diet, or is that something else your talking about?

[HopeandAgony 566]

BCBS IL P. P. O. Doesn't require a 6 month diet.

BCBS IL H. M. O. Does requires a 3 month monitored diet.

There are different requirements depending on the network.

Additionally, if your BCBS IL P.P.O. is employer covered it is possible that your employer had elected to NOT cover bariatric surgery so please do your homework.

Edited December 15, 2015 by HopeandAgony

[MrsRP 36]

Thank you all for the input. Called my insurance today. Requirements: BMI, nutrition counseling (no specific duration of time), and psych eval.

Copay of $250 and if I pre-cert my hospital stay (calling them to let know when my surgery is) I don't have to pay the $300 copay for hospital.

Hoping my surgeon clears me soon so I can get this done. And for a sum of $250 plus any other copays for exams etc, oh I would have done this a long time ago!

[LadyWarren 57]

BCBS IL P. P. O. Doesn't require a 6 month diet.

BCBS IL H. M. O. Does requires a 3 month monitored diet.

There are different requirements depending on the network.

Additionally, if your BCBS IL P.P.O. is employer covered it is possible that your employer had elected to NOT cover bariatric surgery so please do your homework.

I have done my homework, however, it's always more to learn which is why I asked her the question and posted this topic in the first place. And I already know the employer doesn't have to cover bariatric surgery ... so Please don't be rude we are all up here to learn and help others. I don't need anyone telling me what I need to do homework in. Maybe you should read more carefully, and go back and read other post before making these type comments. Thanks in advance!

Edited December 15, 2015 by LadyWarren

[LadyWarren 57]

Thank you all for the input. Called my insurance today. Requirements: BMI, nutrition counseling (no specific duration of time), and psych eval.

Copay of $250 and if I pre-cert my hospital stay (calling them to let know when my surgery is) I don't have to pay the $300 copay for hospital.

Hoping my surgeon clears me soon so I can get this done. And for a sum of $250 plus any other copays for exams etc, oh I would have done this a long time ago!

Yayyy... congratulations! This is what I was asking you, and what I thought was confirmed:)

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