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bcbs of illinois

My paper work was sent in today. I am so hoping to hear something back from them soon! getting excited now!!!! did everyone who has bcbs of illinois have good luck w/ them?

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I wouldn't say I have had bad luck with them, but they told me in the spring that i had to have 3 months of dietary supervision and then once I did that they denied me and said I needed 6 months. I am now on month 5. Let me know what you find out!!! Good luck!

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Good luck to you too, I know how frustrating it can be. Hang in there ;) Will be here soon for ya. that's what happened to me too. ugh. aggrivating i know.

]I have BCBSL and I work for a County government. Once the surgeon's office submitted all the required documentation that included my previous records from 2 weght mangement programs, and all my tests for sleep Apnea, psychological exam, exercise evaluation, prior medical conditions etc, my approval was completed and sent to the surgeons in 2weeks!! You can find all requirements on the BCBSIL webpage or they will send it to you that way you will know if you meet all criteria.. It also depends on the policy they established with your employer.

Good luck with your results & upcoming surgery.

  • 3 months later...

HI i also have BCBS-IL. When i went to my surgeon i was told i had to do 6 mos of carewise though my work cause they required that. It has been over the phone with a Dietician and a Nurse. I am on my 5th month of that. I also had to sumit letters from my family MD and Surgeon to this Carewise. I am really hoping that when I am done with that next month I can get a fast approval. I have my heart set on a late April early May banding.

I have been denied 2x this month alone by them. I meet all the criteria and have all the paperwork but now they are saying it isn't a medical necessity. I have a BMI with no comorbitites and I have proof of attempted weight loss for god more than 24 months, I have had 2 nut apts, 1 psy evaluation, consultation, seminar and a PCP letter along with 5 years of medical history. I guess being a healthy fat person you can't get surgery. Don't worry I'm am going to fight onces more then just give up and realize they must know something I dont'

According to the policy i read if your over 40 bmi then you dont need comorbidities. My bmi is 41 and i have hypertension as well as I am insulin resistant which counts if i am not wrong as Diabieties. I am really still hoping to be approved at least by mid april so i can get a May surgery date. Keep fighting it though. My surgeon has a Lawyer that sends letters to the insurance to fight for you if you get denied.

  • 3 weeks later...

I have BCBSIL. Last year I applied and was denied. I appealed and was denied. So I've applied again. My bmi is 37.5, I have high blood pressure, severe sleep apnea, swelling in my feet, spine pain, yada yada yada. I purchased a book called Lap Band Insurance Secrets.

The book had all kinds of hints. Check lists. Forms, etc.

I have followed all of the hints.

I have jumped through every hoop I can find. We'll be turning in my paper work next week. I pray that this time the insurance company will approve.

I wish each of you good luck.

I was lucky in that I had been seeing my doc. monthly with weigh ins...and i kept a daily log of every bite I took. I gave it all to my doc. who signed off on it. I saw a dietician My sleep doc, my family doc, the dietician, the surgeon all prepared reports to send in. I'll keep you informed.

Debra

I just got off the phone with BCBSIL about an hour ago. My sixth appointment for my six month pre-op diet is tomorrow and I found out today that they've done away with the pre-op diet altogether. Has anyone else heard this?

I just got off the phone with BCBSIL about an hour ago. My sixth appointment for my six month pre-op diet is tomorrow and I found out today that they've done away with the pre-op diet altogether. Has anyone else heard this?

I hadn't heard this. WOW that would be great. I got a letter from them just 2 weeks ago saying I had to have the 6 month diet. I fooled them. I had it. My paper work went in Monday. Now I'm waiting to see if they approve me.

If you go to their website they have the requirements listed and there is no diet anymore. The date on the document is 2/2012 so it must be a very recent change. Good luck everyone. Hopefully I'll be submitting the request to insurance tomorrow!

If you go to their website they have the requirements listed and there is no diet anymore. The date on the document is 2/2012 so it must be a very recent change. Good luck everyone. Hopefully I'll be submitting the request to insurance tomorrow!

Could you tell me how to find it on their site?

I knew there had been a change to their requirements on 2/1/12 but they told my surgeon and sent me a letter stating....No longer need a physicain suppervised diet . instead need six months document diet, non surgical.

I don't doubt you at all. I think they tell different people different things. i sure would like to find that statement, make a copy of it and be prepared ... i f they turn me down i will show it to them.

ahhh! I hope you ladies are right! I have a call in to the surgeons office!

I'm on my cell phone but I think I can post a link to the document:

http://medicalpolicy...t=Surgery#hlink

Thank you! this is the part I was refering to.

2. Evidence that comprehensive non-surgical treatment of morbid obesity has been attempted prior to surgical treatment of morbid obesity:

  • Documentation of active participation in a comprehensive, non-surgical program of weight reduction for at least six (6) months, occurring within the twenty-four (24) months prior to the proposed surgery.

I had to prove that I had attempted to lose the weight and had participated in a program for at least 6 months. I am thankful I had been going to my doctor and she had kept great records saying we discussed diet and she had weighed me at each visit. I had the 6 month documentation...if they accept it.

They sent me a letter saying Weight Watchers, Nurtisystem, Jenny Craig, etc. were acceptable if I had done them 6 consecutive months. which I hadn't

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