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Bcbs...is It True?

ilikebunnies

By ilikebunnies, in Insurance & Financing

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ilikebunnies    48

ilikebunnies
Posted

So I am almost finished with my third month of pre-op diet. I called BCBS today to find out about the nitty gritty of the coverage requirements so I am ready when my consultation comes around. The rep tells me that this year the requirements changed and you don't need the 6 month pre-op diet any more. Does anyone else know if this is true? I don't want to get too excited to find out later that she was wrong.

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shuckybucky    107

shuckybucky
Posted

It is possible. They have made a lot of changes. Ask them for the policy change in writing or just ask your surgeon.

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2muchfun    8,928

2muchfun
Posted

Yeah, I went through the 6 months of BS and jumped through the hoops to find out they had changed the rules. Oh well, banded and sort of happy.

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twelch    0

twelch
Posted

I started process with BCBS last January and had surgery in May...I had to lose like 10% of my weight, not 6 months wait...

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Hopeful to be full    11

Hopeful to be full
Posted

BCBS is a company name but there are hundreds of divisions of the company in each state. you need to look online or call a rep to see what particular requirements are for your division. For example I live in PA and had BCBS but it was BCBS or Northeastern PA (Northeastern PA being the division). You can't just ask someone else with BCBS what the requirements are, each division is different, u need to know about yours.

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NWgirl    574

NWgirl
Posted

Usually you can see the most current benefit book online and it should have the bariatrics policy in writing. I recommend looking into that to see what you need to do.

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Bel12    13

Bel12
Posted

I have bcbs-il and there is only one requirement. If your bmi is under 40 you need a comorbidity. Mine is above 40 so I just need a note from my doc saying that. My surgeon requires a 1 week liquid diet and a chat with a psychologist which I already do. He said it will take 2-3 months until I'm banded

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2muchfun    8,928

2muchfun
Posted

Steph and Hopeful are both right on. If you haven't set up your online account with your BCBS affilliate, do so. Then this will no longer be a mystery and you won't have to rely on strangers for this kind of advice.

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ilikebunnies    48

ilikebunnies
Posted

Yeah, I went through the 6 months of BS and jumped through the hoops to find out they had changed the rules. Oh well, banded and sort of happy.

Sort of? Why sort of?

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ilikebunnies    48

ilikebunnies
Posted

I have bcbs-il and there is only one requirement. If your bmi is under 40 you need a comorbidity. Mine is above 40 so I just need a note from my doc saying that. My surgeon requires a 1 week liquid diet and a chat with a psychologist which I already do. He said it will take 2-3 months until I'm banded

Nice hopefully mine will go as smooth!

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ilikebunnies    48

ilikebunnies
Posted

I found the policy on-line (I have BCBS of Texas) and it says what the rep did, no six month diet any more!

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ilikebunnies    48

ilikebunnies
Posted

BCBS is a company name but there are hundreds of divisions of the company in each state. you need to look online or call a rep to see what particular requirements are for your division. For example I live in PA and had BCBS but it was BCBS or Northeastern PA (Northeastern PA being the division). You can't just ask someone else with BCBS what the requirements are, each division is different, u need to know about yours.

The BCBS rep is the one that initially told me :)

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2muchfun    8,928

2muchfun
Posted

I like bunnies,

I'm due for fill #6. Not enough restriction so far. The lapband is helping but not doing what I had hoped it would do. I haven't given up and still think it can help me lose but so far it's not what I had hoped for.

tmf

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ilikebunnies    48

ilikebunnies
Posted

I like bunnies,

I'm due for fill #6. Not enough restriction so far. The lapband is helping but not doing what I had hoped it would do. I haven't given up and still think it can help me lose but so far it's not what I had hoped for.

tmf

Keep at it I am sure you will hit the green zone :) I am thinking of having plication with my band because I am afraid I will struggle losing the weight otherwise.

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Sunshyne068    97

Sunshyne068
Posted

Does BCBS cover plication? I have Fed BCBS and its not covered (or it wasnt covered 6 months ago)

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Go To Topic Listing Insurance & Financing

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    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
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    • KimBaxleyWilson

      KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
      · 0 replies
      1. This update has no replies.
    • bellaamey

      bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
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