Anthem BCBS Insurance Approval / Denial Question

[emardee 192]

Tash, I saw my doctor for about eight months, worked through the tests, approvals, counseling, etc. Then surgery had to be postponed (two days before I was scheduled) because they found out I was severely anemic. I was on Iron for six more months, then they found out I had bleeding ulcers, had to take medication to heal those, yada yada. From my first appointment to date of surgery I'd say it was about 18 months.

@@emardee did you see your doctor for 6 months?

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@@emardee did you see your doctor for 6 months?

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[kmsull617 4]

@@Tashagirlxo , when do you anticipate your procedure? I already completed step one with psychologist and he sent me to 'immersion day' pre op one day session - I said do you think I'll have my procedure by March and he said 'oh I think before that' so I have February in my head. Hopefully I'm not setting myself up for disappointment.

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[BigTexasMandy 60]

I live in Texas but my employer is based out of Georgia. I am not sure if where I live makes a difference. Technically, I'm considered corporate but we have "local" or "regional" employees who's insurance coverage can vary. For example, employees in California can get (or have to get - not sure) Kaiser Permanente insurance.

I personally am in my six-month diet phase just worried about the potential for rejection. I am not sure why I thought it would be a good idea to schedule my next appointment the Monday after a food holiday. The following appointment will be the Tuesday after Christmas.

It's amazing how much weight can fluctuate. I'm also battling bad depression so I'm hoping she takes mercy on me and that Anthem BCBS does as well. Hopefully, as long as I lose enough to show a net loss it will be okay.

This month has certainly scared me so I will be making better choices and hopefully not stress. I hope to do what @@Djmohr suggests which is take it one obstacle at a time. In the end, it will work out the way it is meant to...

I just wish it were easier to seek approval and that there was more support. In the end, isn't it more affordable for insurance if I weigh less and don't end up with weight-related health issues?

[kschultz007 6]

I live in Alabama but have bcbs of Tx. With my particular plan i don't have a 6 month waiting period. As long as I meet bmi and all pre apts I'm good

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[BigTexasMandy 60]

I wish I lived in Dallas. My husband's company (although we are in Austin) allows BCBS of Texas if we live in Dallas but not Austin. He has to go with Aetna. Sigh. Stupid insurance.

I live in Alabama but have bcbs of Tx. With my particular plan i don't have a 6 month waiting period. As long as I meet bmi and all pre apts I'm good


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[Tashagirlxo 41]

@@kmsull617 should everything go well it should be in January. I'm just hoping they don't require the 6 month supervised diet. I'm preparing for the worst just in case. I started this whole process the beginning of October. It appears that the 6 month supervised all depends on the state. I would just prepare for the worst which would be another couple months of waiting. We shall see

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[wdwfan20 0]

@@Mandy Vachon I gained 2 lbs in between my 1st and 2nd appointments. I was down only a net of 3 lb at my 3rd and final appointment. I was still approved the first time. I think they really look at everyone individually for approval. I have had good experiences so far with them. Rely on your dietitian and doctor's advice here.

[kschultz007 6]

@@kmsull617 should everything go well it should be in January. I'm just hoping they don't require the 6 month supervised diet. I'm preparing for the worst just in case. I started this whole process the beginning of October. It appears that the 6 month supervised all depends on the state. I would just prepare for the worst which would be another couple months of waiting. We shall see

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Just depends on your plan. Not state

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[virginia_stateofmind 0]

Anyone have BCBS Anthem cover Lapband then Bypass?

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Edited December 1, 2016 by virginia_stateofmind

[soreadyforachange 5]

Just found this thread - I'm pre op now with Anthem bcbs. Any update on how this process went for you?