Jump to content
×
Are you looking for the BariatricPal Store? Go now!

My surgery application was denied by Fed BCBS.



Recommended Posts

I also have FEP BCBS. I was sleeved on December 14 2016. I, too had to have all of the requirements you mentioned. I also know someone else who was sleeved earlier in the year with the same insurance, and he also had those requirements. I really hope the peer to peer helps you out! Good luck!

Sent from my SM-G920T using the BariatricPal App

Share this post


Link to post
Share on other sites

If you were seen even for an annual physical and were weighed then you can use that info to appeal.

Sent from my iPad using the BariatricPal App

Share this post


Link to post
Share on other sites

You know, I just have to say this....I don't understand insurance companies. Doctors and insurance companies are so quick to say that our health problems are due to being overweight, but the insurance companies refuse to pay for anything weight related. Can't they see that if we weren't so overweight, that we wouldn't have as many health problems, thus they would save money?? I just can't understand how they haven't come to this conclusion yet. UGH!! I had to pay for my surgery out of pocket. They won't cover anything weight related at all. So ridiculous.

36% of Americans are obese. I think they worry it would bankrupt them if they made it easy for 116+ million people to have a $20,000 operation. Given that that equals 2 trillion 320 billion dollars, I get why they want to make it hard to get approved.

Sent from my iPhone using the BariatricPal App

Share this post


Link to post
Share on other sites

You know, I just have to say this....I don't understand insurance companies. Doctors and insurance companies are so quick to say that our health problems are due to being overweight, but the insurance companies refuse to pay for anything weight related. Can't they see that if we weren't so overweight, that we wouldn't have as many health problems, thus they would save money?? I just can't understand how they haven't come to this conclusion yet. UGH!! I had to pay for my surgery out of pocket. They won't cover anything weight related at all. So ridiculous.

36% of Americans are obese. I think they worry it would bankrupt them if they made it easy for 116+ million people to have a $20,000 operation. Given that that equals 2 trillion 320 billion dollars, I get why they want to make it hard to get approved.

Sent from my iPhone using the BariatricPal App

I don't think that every obese person would opt to have surgery, but I do still think they should pay for weight related issues. My surgery didn't cost $20k, closer to $8k. Weight related issues cause insurance companies to spend a ton of money, so I do still think they should pay for weight loss help. I believe it would save money in the long run due to the amount of money that is spent on weight related issues such as sleep apnea, diabetes, etc, etc. I certainly agree with them having an approval process, but there are some that just downright refuse to pay for anything weight related at all, like my insurance company. Mine does not pay for it at all, appeal or not. It is outlined in our insurance so it doesn't matter what problems you may have. So I didn't have a chance unfortunately. I am not trying to start an argument, its just my opinion. Thanks!

Edited by ready_to_be_thin

Share this post


Link to post
Share on other sites

My paperwork was submitted December 21, 2016 for approval. Jan 3rd 2017 I called and found out I was denied, because I don't meet the New guidelines for 2017. I am really upset about it ????.

I don't think it's fair. Now I need 2yrs bmi >35 w co mobilities 40> w out co mobilities. 90 days NUT , psych eval. I have NUT class and psych eval but I need 1full year with BMI >40.

Has this ever happened to anyone.

Any advice would be appreciated.

Thanks

Sent from my SM-J700T using the BariatricPal App

Paying out of pocket....Cigna Insurance does not pay.

????sonkat5355????

Share this post


Link to post
Share on other sites

It's 11200$ for the sleeve package you stay one night in the hospital too not just an outpatient procedure ! Still nervous though

Sent from my iPhone using the BariatricPal App

Wow that's awesome.

Dr Umbach charges 10,400 cash for outpatient clinic.

Don't worry you Will be fine. I'm sending prayers your way and good vibes . ???? also I don't if you've heard. There's a wonderful support group on Facebook called . Gastric sleeve support group. Gastric sleeve worrier.

They both are closed groups Check them out there is 62k members a lot of veterans and newbies . Best of luck with your sergury.

Keep me posted.

Sent from my SM-J700T using the BariatricPal App

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 1 reply
      1. NickelChip

        All I can tell you is that for me, it got easier after the first week. The hunger pains got less intense and I kind of got used to it and gave up torturing myself by thinking about food. But if you can, get anything tempting out of the house and avoid being around people who are eating. I sent my kids to my parents' house for two weeks so I wouldn't have to prepare meals I couldn't eat. After surgery, the hunger was totally gone.

    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×