Beginning the process and freaking out!

[jessress87 0]

I am at the very beginning of the whole process and I am just going nuts! Last Friday my PCP faxed my information over to my local lap-band surgeon, yesterday they signed me up for an informational seminar for Tuesday 10/13.

I called my insurance company (Blue Cross Blue Shield of Illinois) yesteday and found out that my company does NOT exclude bariatric surgery (YAY!!!) but there is a whole mess of criteria I have to meet (which is to be expected), however, one of the criterion has got me in a panic. While the BCBSIL rep was listing the requirements she mentioned documented weight loss attempts and results for the past 24 months. I've been severly overweight for the last five years or so but I don't really have any doctors records of weight loss attempts. About this time last year I went to my PCP about my weight and they set me up on a diet plan and prescribed me Adipex, unfortunately I didn't follow up.

Does this mean that I'll have to wait 24 more months before I can have the surgery? I see that most people with BCBS had to do 6 months supervised diet, which is fine with me- I think it would be torture to have to wait two years though! I'm so excited about this procedure, I want to get my life back on track! Does anyone have any input about the 24 months thing??

[ericanda1973 1]

Good news for you it is no long 6 months of supervised with BCBS it is now only 3 months, and no 5 year history that took that out. As for the last 24 months. did you do WW or anything like that? I had not actually been to the dr with my Weight but I did do every diet known to man , so on my papers i got from the bariatic dr I had to write them all down. Just go to ur PCP dr every month for 3 months and tell them EVERYTHING your doing different now to try to lose weight, I am insured and work for BCBS and it took me a year from start to finish to get my surgery, but that was when you had to have 6 months of dr. supervised diet not the 3 months they require now. Also if you get denied the first time(and most likely you will) Fight it. Good luck Hope this helps relieve any concerns you have.

[AbbeMac 0]

I have BCBS Minnesota and they require the 6 months with a nutritionist, supervised diet. I was told by the bariatric staff here that the State BCBS's have stronger requirements than the national.

[ldswims 0]

The best thing I can say is get in there to do the consult with the surgeon's office. They will spell out for you exactly what you need to do - and they will hold your hand while doing it. It might help to find an office that is like that, if not.

Even if it is 2 years, so what? For two years, this surgeon's office will be weighing you in and hearing what you've tried - and will give you ideas for new things to try. They will, over the span of this, get you used to how you will HAVE to eat after surgery. So this two years might not be the immediate result you want, but so what? It's a step in the journey.

And it may not be two years anyway. When you go in for your consult they will have verified what the requirements are to see if you are eligible on the insurance side.

I am right there with you. I just started this process last week and thought there would be a quicker turn around on this process. But there isn't. For me it was six months - and six months was enough to make me freak out, too. But over the past week I've realized this is an incredible opportunity. Instead of having to go cold turkey on everything I do - sodas being my worst habit, I'll have some time to ween myself before these habits can truly cause pain. The surgeon's office I am going through referred me to a clinic that has everything in place for people to hold my hand all the way through this, including submitting and probably resubmitting my paperwork after the six months are over.

And when I think about it, I'd be setting myself up for failure if this wasn't required.

It will be fine - and what's the worst that comes with supervised weightloss, really?

[ladybug97 0]

I have BCBS of Illinois too! I simply had my PCP fax my weight record dating back 24 months to BCBS. Then, I had to be on a weight loss plan for six months, which the Weight Loss Center Supervised and documented for me. I was initially bummed about having to wait six whole months, but the time really did fly by.

[jessress87 0]

Thanks for your support everyone! I'm feeling more confident already. I decided to get a journal and log all my steps in the process, it helps me feel more organized about the whole thing. I'm willing to wait as long as I have to to get this done but it would be great to get it sooner rather than later.

[jessress87 0]

I have BCBS of Illinois too! I simply had my PCP fax my weight record dating back 24 months to BCBS. Then, I had to be on a weight loss plan for six months, which the Weight Loss Center Supervised and documented for me. I was initially bummed about having to wait six whole months, but the time really did fly by.

You don't know how relieved I am to hear that someone with the same insurance as me has been successfully banded! I've been going to the same doctor practically since I was a kid (I'm 22, still technically a kid if you ask me!). I've been to the office several times in the past few months and I'm sure a time or two before that in the past 24 months but the only time I remember them weighing me was at my appointment last week when he referred me to the surgeon and last year, probably around July when I went to see about a weight loss regimen. Hopefully that will do!

[isaviolinist 11]

I have BCBS of NEPA and I didn't need to do a supervised diet. I just got my entire history from family doctor (they just printed my chart for the past 5 years) and I gave it to my surgeon. I did all the preop testing and that was enough for approval.

I will say that my hospital is labeled a "BCBS Bariatric Center of Excellence" by Blue Cross. I think that this helped a lot in getting approved literally in like a day. Maybe you should try to find a hospital in your area that BCBS works closely with (that also has a reputable bariatric program). It may make the insurance side of things go more quickly and smoothly.

[jessress87 0]

I have BCBS of NEPA and I didn't need to do a supervised diet. I just got my entire history from family doctor (they just printed my chart for the past 5 years) and I gave it to my surgeon. I did all the preop testing and that was enough for approval.

I will say that my hospital is labeled a "BCBS Bariatric Center of Excellence" by Blue Cross. I think that this helped a lot in getting approved literally in like a day. Maybe you should try to find a hospital in your area that BCBS works closely with (that also has a reputable bariatric program). It may make the insurance side of things go more quickly and smoothly.

I did some checking and I found out that the facility where I am planning on having my procedure is a 'Blue Distinction Center for Bariatric Surgery' although I'm not 100% sure what that means, sounds good though Thank you so much for the input, everything that anyone has to say is so precious to me right now- I'm just soaking it all up!