BC/BS PPO of IL: Will they approve me?

[jog312 0]

My insurance policy is a PPO with BC/BS of Illinois. In order to cover the procedure, I must have:

a) A diagnosis of morbid obesity (BMI of 40 or more)

-and-

:rose: At least 2 co-morbidity conditions: Hypertension, Dyslipidemia (high cholesteral), Diabetes, Heart disease, Sleap apnea

-and-

c) at least a 5 year history of morbid obesity supported by medical records

I'm not sure that I meet all of those qualifications. Certainly, my BMI is over 40, but it hasn't been that way for 5 years. And I'm not sure that I have 2 co-morbidity conditions.

I'd hate to go all the way through the 6-month medically supervised diet, and then find that BC/BS will deny me. Is there any way I can find out in advance whether I'm likely to be denied, and thereby save myself the time and trouble and just focus on the self-pay option? Anyone out there have experience with BC/BS of Illinois denying coverage at the end of the 6-month diet program?

--JOG312

[pjn2005 0]

My insurance policy is a PPO with BC/BS of Illinois. In order to cover the procedure, I must have:

a) A diagnosis of morbid obesity (BMI of 40 or more)

-and-

At least 2 co-morbidity conditions: Hypertension, Dyslipidemia (high cholesteral), Diabetes, Heart disease, Sleap apnea

-and-

c) at least a 5 year history of morbid obesity supported by medical records

I'm not sure that I meet all of those qualifications. Certainly, my BMI is over 40, but it hasn't been that way for 5 years. And I'm not sure that I have 2 co-morbidity conditions.

I'd hate to go all the way through the 6-month medically supervised diet, and then find that BC/BS will deny me. Is there any way I can find out in advance whether I'm likely to be denied, and thereby save myself the time and trouble and just focus on the self-pay option? Anyone out there have experience with BC/BS of Illinois denying coverage at the end of the 6-month diet program?

--JOG312

Hi ,I am from central Illinois.I have Bc/BS .and I just got approved.I went through the 6 month diet .After my 6 months it only took a couple of weeks to get the approval .I have my surgery Nov.13.Hang in there:).The time goes by fast.Penny

[BensonRN 0]

I am in the process of trying to be approved also. I went to the dietician she did not put me on a diet she just told me about life after banding. Am I supposed to be on a supervised diet to get approved?

[CyndyG 0]

I have BC/BS PPO, I just got my approval letter Friday. I had to have a BMI of 40, and had to do a 6 month diet, and get approval from a heart, respiratory, and phyc. Dr. I also had to give them a copy of the last 5 years of being over weight. I had to lose 15lbs for approval. Im waiting for my surgery date. Its taken me 9 months to get here. I hope its all worth it.

[illinoishusker 0]

I have BCBS of IL. I just got approved Thursday.

I do not have any co morbidities. I am over a 40bmi and I have over 5 yrs of obesity.

I did the 6mth diet.