General motors bcbs

[MizzouFan1 88]

Hi guys,

I was wondering if anyone out there has dealt with General Motors BCBS? I have had 12 months of weightloss (and regain) but nothing I would classify as clinically evaluated- what in the heck does that mean anyway:confused2:? I have PCOS and my(gyno) doctor tried Glucophage to get my insulin resistence under control and that didn't work- I wonder if they would consider that as 12 month documented weightloss attempt? Anyone that has any good advice- please please share. I am re-starting this journey - I tried back in summer of '07 and got discouraged by the requirements.:wink_smile: THANKS GUYS!

[nazzy 1]

i have bcbs michigan i needed a 6 month diet from my dr so every month ive gone and weighded in costed me 89 dollers each time with my insurance but bcbs doesnt cover the diet weigh in part,anyway saw lap ban dr other day,see nutrisnest thru and pyshco exam thur i made these ahead whn i knew i was close to 5 months diet,i didnt gain pr lose any and fri they will mail to bcbs it and i see what they say ive been over weight 15 yrs plus i had double knee replacemnts last yr,im sure ill have surgery date soon sh says takes 30 days or less to hear back ,because she jas to mail em they wont take faxed resluts.lmk what happens with u,thats my story cant wait till my date after date i do tests im ready.

[nazzy 1]

p.s its general motors i have,plus i hear dont know of true but nxt yr they may not cover it gm so id get moving,someone told me this at lap band dr office ,may opr may not be true but id hurry

[MizzouFan1 88]

Thats odd, because the criteria I need to qualify is different than that. They said I had to have 12 month failed weight loss attempt documented by PCP and psch eval, letter or medical nesseccity, and a BMI of at least 40. I wonder why there would be different requirements? Yeah I am in a hurry because I get kicked of my parent's insurance in FEB '09.

[nazzy 1]

im not sure but i tell ya 6 months was along enough i went to my dr.she sent ina note saying i was ona diet with her for 6 monthsmthats all i needed plus pyscho eve and nut mi have them done tomarrtow,then they call me when the sumit them to bcbs michigan,then i get a date and tests,lmk

[nazzy 1]

also did u go to the seminar?i also called bcbs mys elf cause i couldnt get aright answer,maybe that will help

[MizzouFan1 88]

I called them myself. I am in KC and I called the number of the back of my BCBS card and that is what they told me.

[nazzy 1]

im louisana maybe thats why,not sure but id be bummed 12 months but id still do it,i know i had to pay 89 each month at dr

[MizzouFan1 88]

hi Nazzy,

I had so many different answers and I finally called Michigan BCbS and not the number on my card and they gave me the same criteria that you have(I think). Psych eval, 6 month diet, BMI >40, letter of medical neccessity. What kind of info did they need for the 6 month diet. Do they accept weight watchers or previous attempts?

[nazzy 1]

hey ,i went to my dr for 6 months she put me on diet,and weighed me at end 6 months she wrote me aletter saying i had done my diet and she said she wanted me to have lap band.then i went pyshco ele i made this appt just before i saw lap band dr so few days later i had the pyshco test done costed me 35.00 for letter head,and the nutrisnest costed me 73.00.now im just seei ng when they gonna mail to bcbs.lm k what happens to you:biggrin:

[MizzouFan1 88]

hey nazzy,

on the 6 month diet- did you have to actually lose weight or keep a food journal? I am excited but i wish I had already done this but we will see.

[nazzy 1]

i didnt gain any or lose,u dont want to lose to much then they might think u can do it with out the bandband,i know that sounds b ad,but thats what i heard,no the dr kept track of it all,so when they make copy of my records its all in there,also i was on jenny craig before and got aletter from them saying yrs back i was on there program,but they only think a dr diet counts its ended up costed me after co pays somethinbg like 89 a month to see my dr,its not covered for morbiisty.that was my co pay included since i only f got 5 visits my family for 25 beg year,see yr dr right away start the 6 month deal,she was cheapest way to go.

[jillissac 0]

I have GM Anthem BCBS. I am just beginning my journey down the approval path. My BMI is <40 but my PCP is all for me getting lapband. He is writing up comorbs for insurance to approve. I have psych eval 7/16, stress test 7/17 and first appt. with lapband Dr. 7/29. I went to the seminar and spoke with the Dr. and he seemed to believe it would go through. Keeping hopes high. Jillissa