Anybody have BCBS Horizon of New Jersey out there?

[lasmith0802 67]

Just wondering how things with insurance approval. My initial weight in my BMI was 40, since then I've lost around 12 pounds my BMI now down to 37.9. Fingers crossed I will still be approved.

[NikkiDoc 312]

I have Horizon BC/BS. Initial BMI was 45.35. BMI at time of approval was 41.6. I had high blood pressure and GERD as co-morbidities. However, the guideline was BMI of 35 and less needed a co-morbitity and anything over 35 did not. The BMI was based on the date I entered the program not on the day of surgery. They want to encourage you to loose weight during the 6 month pre-approval diet.

My program submitted the medicals to BC/BS on a Tues morning and I had approval on Friday afternoon. I worked with an Optum bariatric case manager during the whole pre-op.