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Anyone else have bc/bs insurance



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I have to have a 5yr medical history! Well that is not a problem however my doctor never did monitor my dieting. I have never gone to anyone other than say Jenny Craig, Weight Watcher, or diet pills I may have purchased from the drug store. Seems that they also want to know if I have any health risk, dibetic, heart problems, hypertension or sleep apthia.

Help me out here please, if anyone has BC/BS I would like to know really how hard this is going to be to get approved for this banding surgery!

Thanks

Michele:cry_smile:

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I had BCBS (was banded in 2006), had no co-morbidities other than a little arthritis and pain in my knees. BCBS made me show the 5 years proof of being morbidly obese for at least that long, provide pictures of myself, go on a 6 mos medically supervised diet (the Weight Watchers, Jenny Craig didn't count) and still complete the nutritionist consult, psychologist cosult and the other pre-op testing. I hung in there and got approved on the first submission after getting all this info. Oh, and a letter from your primary care Dr. with their info about you, height, weight, health and all your medical records for the last 5 years as well. Make sure if you do the medically supervised plan that the Dr. documents your weight in your chart and your discussions about weight loss, eating habits, etc.

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I also have Bc/Bs (NewJersey) and they also requested 5yr history of just my height and weight from my Primary Care. When it came to what Diets i have tried me and my Pc sat down and went over that before they wrote the letter. I really did'nt try that many diets, my PC just worded it well:closedeyes:. and being that i am Type 2 Diabetic and had been over weight most of my life ,they supported and actually came up with the decision first:blush:. i think that helped getting me approved:thumbup:, i just regret i didn't act upon it 3yrs ago when they first suggested to me:bored:

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I too have BC/BS.... BMI 44 when I started and no comorbidities

Gave a 5 year diary...

Because it had been more than 2 years since my last "supervised" diet attempt of 6 months duration... I did the 6 month diet ( lost about 5 lbs...but focused on behaviors... protien first,chewing well, fluids not with meals, etc)...

Once I finished the "diet" approval went through quickly and without a problem.

Good Luck!!!!

Edited by mammanan
typo

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I have bc/bs of greater New York. Just to let all of you know that its not the insurance companies fault but the employer. I found this out the hard way. Myself and my wife both have the same insurance but different plans. That's the key. My employer opted to purchase the cheapest plan they could and it does not cover any bariatric procedure,obesity study or even nutritionists. My wifes plan covers all so obviously I dropped mine and went on hers or this would never have been possible. I had a records file thicker than a phone book with all of the problems. Diabetes,hypertension,sleep apnea,heart trouble, swelling of the legs, joint pain high BMI etc... It meant absolutely nothing to them because of the plan the emloyer chose. They would rather pay hundreds of dollars a month for doctors and medicines which makes no sense. My doctor even wrote them a letter explaining how much this would help me liVe longer and relieve most of my problems but twice they turned me down. Some people have had it overturned but you and your doctor need to be persistent. Good luck to everyone and hopefully it works out for you like it did for me.

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