Florida BCBS ***

[Miss.ferby 2]

Hey everyone , I'm new to this forum and I wanted to ask if anyone has FL Bluecare ***?

I wanted to how many "hoops" my surgeon and I would have to jump through (so to speak) before getting approved... I have so many questions, and I think I have called to get information so many time that I know the breakdown of the benefits by heart lol

I just want this surgery to work out... I have spent my whole life gaining, and losing, and gaining and just being obese... I am tired of feeling like this, I want to better myself and this is really my last option.

[cubyblue6 61]

I have BCBS IL, I don't know if it's the same but honestly I didn't have to do anything special. I met the weight and BMI requirement and that was all I needed. Hope it's the same for you. Good Luck!!

[Goldn02Grl 148]

13 hours ago, Miss.ferby said:

Hey everyone , I'm new to this forum and I wanted to ask if anyone has FL Bluecare ***?

I wanted to how many "hoops" my surgeon and I would have to jump through (so to speak) before getting approved... I have so many questions, and I think I have called to get information so many time that I know the breakdown of the benefits by heart lol

I just want this surgery to work out... I have spent my whole life gaining, and losing, and gaining and just being obese... I am tired of feeling like this, I want to better myself and this is really my last option.

I don't, but I am in St. Pete! I am 25 days post-op (best decision EVER)...best thing to do is call your insurance and ask (a local bariatric surgery office can give you the code to ask with). Good luck!

[Miss.ferby 2]

@cubyblue6 I have a feeling that I meet the BMI requirements, my BMI is something like 46. I just worry that if my insurance tells me I have to wait the 3-6 month period, and with the special diet pre-surgery, I will no longer qualify... but we will see! Crossing my fingers! 🤞🤞 this is my last hope. Did your BCBS make you do the preliminary dieting and 3-6 month wait?

@Goldn02Grl the coding is what I am missing... without a definite code BCBS says they may not cover. Technically, WLS and anything weight loss related is excluded from my plan, but if it's "medically necessary" they MIGHT give me an authorization. Maybe. Congratulations on being post-op! Are you feeling ok?

[cubyblue6 61]

I know this is a super late reply but how did it go? I didn't have to do anything special, no 3-6 month diet. I believe my BMI at the time was roughly 48-ish. And I didn't have any comorbidities although I was working on having high blood pressure. I hope it worked out. I lost about 30 pounds before my surgery but I think they use the info from when you submit

Sent from my SM-G975U using BariatricPal mobile app

[Tinkerbellemom 1]

I have BCBS thru Publix, my husband works there. The place I chose is a preferred provider, so I was happy about that. BUT the Publix version of the plan specifically excludes any type of weight loss management...No surgery, no counselling, no meds, nothing. The policy mentions even if you have a qualifying condition that weight loss treatment would improve and your physician determines is medically necessary, it will not be covered. When I was fussing about this to my hubby his reply was...of course Publix isn't going to want any procedure covered that will make you need less food. Insurance companies write the policy, but it's the HR department of the company that ultimately decides what it wants covered to fit it's needs. Exclusions save money on premiums. And we all know that's the ultimate bottom line, not the health of employees and families.