BCBSIL Insurance questions

[Samantha89 2]

Hey everyone.. I finally have some decent insurance through BCBS IL. I called them and they told me

all I have to do to qualify for surgery is have my doc submit a pre-authorization.. yet I keep reading different things. It's really hard for me to believe it would be that simple. I do have my first appointment on Monday 01/30/17 with my doc, super excited to start. I found a snippet in the medical policy saying 6 months of supervised diet is no longer required. I guess I will Find out Monday! If anyone has any info that would be greatly appreciated!

bcbs.pdf

[sleevinpops 303]

Each is different, I had a 6 month supervised and initially hoped it were sooner, I am now great full as I have been able to get my mind and self really ready for this. Our life and old habits are gonna change, and the time allows for us to be really ready to make sure we will maintain.

Now only two weeks away, the first 6 months flew, but feels like forever on the next 2!

Good luck on your journey! Hope to read about your progress?

Sent from my iPad using the BariatricPal App

[Samantha89 2]

Each is different, I had a 6 month supervised and initially hoped it were sooner, I am now great full as I have been able to get my mind and self really ready for this. Our life and old habits are gonna change, and the time allows for us to be really ready to make sure we will maintain.

Now only two weeks away, the first 6 months flew, but feels like forever on the next 2!

Good luck on your journey! Hope to read about your progress?

Sent from my iPad using the BariatricPal App

Thank you so much! I have been trying to get the surgery done since 2014, was almost approved then my insurance company (not BCBS IL) changed requirements. I got a new job and didn't want to take off too much time too soon so it looks like now is a great time. My boss is fully supporting me. I have been able to take off about 50lbs since July so I'm really trying here!! My mother also had bariatric surgery years back, so I feel like im pretty ready! Thank you so much! I will update when it happens

[sleevinpops 303]

That's great! I didn't know the history, but sounds like your ready to go! You may be able to shorten the time if you can show that you have been actively working on a weight loss goals. Check with your PC he can probably recommend too.

You got this!

Sent from my iPad using the BariatricPal App

[ANewMe2017 10]

I have BCBS-NY , the paperwork says 6 supervised months, but if your "situation is serious enough" they are able to bump up the date, it just depends on what your doctor says.

Sent from my SM-G930T using the BariatricPal App

[jennifer1 180]

i have BCBSIL and i saw that about not having to do the 6 month diet, which is true. HOWEVER, i have a lap band and im trying to get it removed and revised to the sleeve. i have been denied twice, basically due to paperwork. they first said my paperwork didnt show it was medically necessary to have my band removed, then we submitted with more paperwork. Now they are saying they thought my band was removed in July so they denied me again!! Currently they are reviewing my paperwork AGAIN!!! So i would just advise that all the documentation they request is submitted correctly!!! Best wishes to you!

[Samantha89 2]

i have BCBSIL and i saw that about not having to do the 6 month diet, which is true. HOWEVER, i have a lap band and im trying to get it removed and revised to the sleeve. i have been denied twice, basically due to paperwork. they first said my paperwork didnt show it was medically necessary to have my band removed, then we submitted with more paperwork. Now they are saying they thought my band was removed in July so they denied me again!! Currently they are reviewing my paperwork AGAIN!!! So i would just advise that all the documentation they request is submitted correctly!!! Best wishes to you!

I sure hope they get your paperwork corrected ASAP and you can get your revision, it's so frustrating!

[sabrinamena 3]

I have BCBSIL, they submitted my pre-authorization on Dec. 12 and was approved on Jan. 9.

Looks like it's going to still be about $10,000 for me though so we haven't set a date

Sent from my iPad using the BariatricPal App

[sablebby 6]

I have bcbs il and all I had to do was labs and psych eval. Along with letter from pcp

[sablebby 6]

I have BCBSIL, they submitted my pre-authorization on Dec. 12 and was approved on Jan. 9.

Looks like it's going to still be about $10,000 for me though so we haven't set a date

Sent from my iPad using the BariatricPal App

That's you paying just about the full amount...what is your deductible if you don't mind me asking

[sabrinamena 3]

My deductible is $750 and my out of pocket is $7,150. Co-insurance is 75/25. I'm honestly kind of confused with all of it!

Sent from my iPhone using the BariatricPal App

Edited January 27, 2017 by sabrinamena

[sabrinamena 3]

I have BCBSIL, they submitted my pre-authorization on Dec. 12 and was approved on Jan. 9.

Looks like it's going to still be about $10,000 for me though so we haven't set a date

Sent from my iPad using the BariatricPal App

That's you paying just about the full amount...what is your deductible if you don't mind me asking

My deductible is $750 and my out of pocket is $7,150. Co-insurance is 75/25. I'm honestly kind of confused with all of it!

Sent from my iPhone using the BariatricPal App

[sablebby 6]

That is a very high coinsurance...that means you are paying 75% of the bill ouch. I'm sorry

[shortyp79 58]

Hey everyone.. I finally have some decent insurance through BCBS IL. I called them and they told me

all I have to do to qualify for surgery is have my doc submit a pre-authorization.. yet I keep reading different things. It's really hard for me to believe it would be that simple. I do have my first appointment on Monday 01/30/17 with my doc, super excited to start. I found a snippet in the medical policy saying 6 months of supervised diet is no longer required. I guess I will Find out Monday! If anyone has any info that would be greatly appreciated!

Samantha89 - i have them too. I only needed 1 dr consult, 1 psych consult, and 1 nutritionist consult. I'm just waiting to hear BCBS IL apprive me.... the dr said they usually take longest. Up to 30 days before approving....!!

Sent from my SM-G930T using the BariatricPal App

[shortyp79 58]

Hey everyone.. I finally have some decent insurance through BCBS IL. I called them and they told me

all I have to do to qualify for surgery is have my doc submit a pre-authorization.. yet I keep reading different things. It's really hard for me to believe it would be that simple. I do have my first appointment on Monday 01/30/17 with my doc, super excited to start. I found a snippet in the medical policy saying 6 months of supervised diet is no longer required. I guess I will Find out Monday! If anyone has any info that would be greatly appreciated!

Samantha89 - i have them too. I only needed 1 dr consult, 1 psych consult, and 1 nutritionist consult. I'm just waiting to hear BCBS IL apprive me.... the dr said they usually take longest. Up to 30 days before approving....!!

Sent from my SM-G930T using the BariatricPal App

....so i'm waiting for approval at this time. Had my psych appt on Monday, Jan 16th... #fingerscrossed

Sent from my SM-G930T using the BariatricPal App