skinnynursebetty

Ok, so I started researcing WLS a few months back and had originally decided the lap band was the way to go, then I found this website and did some more research on VSG and that is the way I'm going now. I have BCBS IL PPO insurance and they require a 6 mo diet and exercise blah blah blah program. I made an appt to see my dr today for my first weigh in and to talk to her about WLS etc. I have only seen this lady a few times, but liked her so I thought she would be perfect to do this for me for 6 mo. So I went in today and had my height and weight done. I am JUST on the border of the 40 BMI my insurance requires so I knew exactly what my ht and wt had to come in at. At home I measured, more than once, at 5'4" and my weight at the drs ofc came in right for that height to put me at the 40 BMI, well I didn't know this til almost the end of the visit but, the nurse measured me at 5'4.5" so it made my BMI 39.7!!!!!!!! I was so upset and tried to explain to the dr it HAD to be at 40 BMI or the ins wouldn't accept it. I came armed to that appt with paperwork from the surgeon, my own printouts of what the VSG was, advantages and disadvantages etc and what she needed to document as far as a low calorie diet and exercise counseling. She was VERY unwilling to help me. She said she knew a little about the surgery but just gave me back what I had printed for her without even reading it! She said they don't have time to do nutrition counseling there and then she told me I should see a psych to find out why I have this issue with food! I'm not at all opposed to that idea, actually think its good but just they way she said it to me. Then she told me after 5 years my stomach would just stretch back out and I would gain the weight back anyways. She told me to go to Weight Watchers and see a psych. I just don't know what to do now. I'm sorry, this is long and I'm rambling. I had already psyched my self for the 6 LONG months of weigh ins and now this just throws a wrench in my plans. Any advice would be helpful. Thanks, FB

Ya me too! I think I will call them tomorrow before I go to my appt Monday! Thanks

Do you think a NP at the drs office is OK? It doesn't even specify a DR in my medical policy I printed online. It just says documentation of active paritipation in a comprehensive, non surgical program of weight reduction for at least 6 months.

That would be great! I'm looking to do this ASAP like most on here are. I have just been discouraged with the diet part. I didn't know I would have to do that, I mean come on I have been on a "diet" for most of my life. I remember being a child and my mom taking me to Sears to buy plus size girls clothes. I could give the ins co a LONG list, but I guess that isn't good enough! SO, I will go to my dr and get it all documented and HOPE and PRAY it works. I wish everyone good luck! FB

Hi there, just wondering if you had BCBS insurance? I have BCBS IL and they say they will take the BMI at the beginning of the 6 mo diet. Maybe they are all different?I would so love to just have the money to go do this on my own too instead of going thru all these hoops. --B

The lady at BC told me WW would be good and then I explained to her how expensive it is ($15/wk or something). Then she told me why not just go to the dr and make sure he is documenting everything they "require", for my regular copay. I asked how often I would have to go and she said once a mo for 6 mo would be good. Now I know she is not a reviewer, but this is info I have gotten from a few of the reps at BC. Also my surgeons office told me it really does depend on who is reviewing your file. They had a mother and daughter everything the same and one got approved, the other denied. I'm looking forward to hearing from all you out there that have BCBS IL so we can compare info. Thanks for all your help and advice!

I have been talking to the insurance co everyday to just get things clear for myself and I think, but don't quote me on this that is just has to be 6 mo. The lady at BC told me I could go to my own dr once a mo and have them document the nutrition, exercise etc and that would suffice. HTH, Beth

HI all, I 'm new to this board. I orginally came from the lap band board, but have decided VSG is the way I want to go. Anyways, I have been reading all the posts about BCBS IL and am quite discouraged at this point. My hub works for UPS and I was just wondering if anyone out there has the same ins with the same employer and what their story was. Thanks, Beth

Your husbands employer wasn't UPS was it? My hub works for UPS and I'm so worried I'm not going to get approved for the surg!

I called a doctor that I wanted to see and he charges $2500.00 for program fees. I also have BCBS and they cover everything 100% EXCEPT for this "fee". I also live in socal if you know of a good doctor that doesn't charge this "fee" please give me their name. TIA!

I have been considering surgery for a while now and have been getting some great information and inspiration from this site. I even found a Dr here. I'm 37 til April, haha married to my HS sweetheart for MANY yrs now and have two boys 9 and 4. I have been overweight my whole life. I remember even shopping in the plus size section at Sears with my mom when I was small. I did lose a TON of weight when my boyfriend, who is now my husband, broke up with me for a while when I was 18. Other than that I have been overweight. I have tried almost every diet out there. I have lost some of the weight before, but it just comes back. I'm looking into the lap band to help me with my weight loss. I like to exercise. I even did a 5k with my sister last May. So, we'll see what happens when I go for a consult. Hopefully we can get the ball rolling and have surgery sometime in the NEAR future! Thanks to everyone here for all the information. It is just wonderful.