Blue Cross Blue S. Of Georga, PPO what...

[CHI-Girl 1]

do they require, pre req's. Also do they give a lot of problems approving? I was advised only to call and ask if the cover Baratric surgery by nurse at surgens office. Not met with him yet, but have the referal and am scheduled for seminar 6th of September. But I guess I'm just paronid. I asked where I could find the details and she said on line looked and no online access. So now what, I'm afraid to call them and ask. Do I just wait till I go to seminar. :thumbup:

My stats:

5' 0.5" Tall

219 (BMI around 41 or 42. I just weight in at doc 2 days ago lost 5 lbs this month so haven't checked BMI)

I have sleep Apnea -Just recieved Cpap machine a week ago today!

I have joint issues tendintas in my knees and back pain which I did theropy and MRI and nothing wrong machenically. :tt2:

I just turned 30!

What are my chances of an easy approval process with BCBS of Georgia (side note I like in IL and have BCBS of GA go figure!!!)

Another side note I'm new here and don't see spell check :cool2: I spell terrible sorry!!! I live and breath spell check guess can't do that here! if their is a spell check plz someone tell me where :wink::w00t:

[*slim* 2]

Hi. First, I so understand about the out of state insurance. I live and work in TN, but my insurance is BCBS of Illinois. :confused2:

To answer your insurance question, it really depends on who provides your insurance (your employer). My employer is a self pay through BCBS so my employer actually determines what is covered and how. If the provider of your insurance does cover it, they still will determine what the qualifications are. The standard qualifications seem to be a BMI of 35-40 with comorbidities (i.e. sleep apnea, hypertension,etc) or BMI over 40 with no comorbidities. Also there is sometimes a supervised diet plan usually through a doctor or sometimes even Weight Watchers is accepted. Then lastly a history of obesity (just doctor's visits showing your weight that can be calculated into your BMI).

I hope this helps.

[Lopez1978 0]

I have BCBS of Georgia and was told I have to do the 6 months of supervised doctor visits to monitor my weight and diet/exercise. Then I have to do a group therapy session and an individual counseling session. I have that scheduled for next week. When that is complete the Doctor submits to the insurance and I will see what happens. I will keep you posted on what their response is.. Good Luck to you.

[CHI-Girl 1]

Yes keep me posted on how it goes for you. I have my first consult next Thursday. I printed up the policy from on line where they told me it was. It does say "the paitent myst have actively participated in non-surgical methods of weight reduction; these efforts must be fully appraised by the physician requesting authorization for surgery". If you ask me that is very vaige! It doesn't state 6 weeks... So I'm hoping that this will be a fast process. Although I have been activaly working with my PCP to loose weight so I hope he has that all documented because I don't want to have to start all over again!

keep in touch.