I have my surgical consultation on 8/2 and I'm a ball of nerves over getting it approved by my insurance! I tried doing a search in the forum for answers buit wasn't able to find much, so I apologize if this has been asked before (which I'm sure it has).

I have Anthem BCBS. I've already verified that Lap Band is covered by my plan as long as I meet the requirements, which I do. Requirements are here:

http://www.anthem.com/medicalpolicies/policies/mp_pw_a053317.htm

I have no co-morbid conditions. My BMI is 46. Everything else is in the works - I've attended the mandatory seminar that the surgeon's practice requires. I also have appointments to meet with the dietician and pyschologist for a mental health assessmeet. After my consult, I will be scheduled for labs, EKG, and the other required testing I assume. I am just wondering if anyone has had a good outcome with their insurance without the co-morbid conditions?

Is it typical to be approved right out the gate for surgery, or do you usually have to jump through hoops? I am just feeling a little overwhelmed with all the what-ifs, and I will be so disappointed if it gets denied. I really want this!

Rachel

I also have Anthem BCBS and I had no co-morbidities and my BMI was also like 45 or 46 and I got approved. I live in Indiana, though that shouldn't matter. As long as you go to all the appointments and do what the dr. says and they can show that in the write-up to Anthem, you should be good to go!

I know what you mean by being overwhelmed and stuff, I was too. Still am actually, because I get banded on Aug. 23 and I'm a huge bundle of joy, nerves, scared, etc.

Good luck though, I'm sure it will be approved.

Missy

I have BCBS of MN...I was a 35 BMI with High Blood pressure and High Cholesterol...i also needed 2 years of BMI higher than 35....I had about 1.5 years of 35..and was nervous....they approved me within 7 days of the doctors office faxing all the info over....i was a nervous wreck....crazed!!! But the approval process went smoothly!!!! Good Luck!!

Thank you both so much! That gives me hope that maybe I will get approved easily too I tend to think the worst with these sorts of things which I know I need to work on - haha. I will definitely keep everyone posted on my results once I found out!

And Missy, GOOD LUCK with your surgery! You will do great!!!!!

I also have Anthem BCBS. You have nothing to worry about. Once your paper work is submitted you should be approved in 5 days. Mine was submitted on a Tuesday and they called my Dr's office on Friday. I found out on Monday. Good Luck!!

I have anthem bcbs and was approved with just bmi of 40. no cormobs...i was actually very healthy...just fat lol...they approved within a week

I have anthem bcbs and was approved with just bmi of 40. no cormobs...i was actually very healthy...just fat lol...they approved within a week

Thanks good info I also have no cormobs.....and was getting worried my next visit to the Dr.7/31/12wow it's a 4in1 visit ekg,labs,nutrition, sleep study ..

.then2more visits and clearance from my pcp.

Thanks

I have anthem bcbs through kroger and was approved in two weeks.

I have Anthem BCBS, at first visit I completed labs,ekg and met with advocat

She said she rarely has a problem with bcbs. I am a 40 BMI with

Pcos,reflux,high bp. But she said I met the 40 so I need a 3 month

Diet. I then spoke up and said I was on medically supervised weightloss program

Off and on for 2 yrs. She said she could get the records and would only need the psych eval. This was Oct 4 2012. She said if all goes well I could be scheduled

Next month. Fingers crossed!

Good Luck!

I just wanted to give everyone a quick update. I was approved for surgery by my insurance and am scheduled for this Thursday to have my lap-band put in! The approval process was so easy and I didn't have to do anything! Now I just wait for surgery!

Wow, this is all very encouraging... I also have Anthem BCBS. I have a bmi of 36, reflux, high BP, tachycardia (not sure if that will help with the approval or not) I have been on WW, phentermine and have even had lipo all in attempts to get to where I want to be...

I am scared to DEATH about my consult and approval!!

Plan it quick! The end of year is coming and your insurance and deductible start over cone Jan 1 2013. I really hope I get scheduled for nov or dec. My out of pocket is gonna be $200. If I get it done next yr with will be $3000.00. I was told being on phentermine through previous weightloss attempts was good enough and my 3 month weightloss requirement was waived. I wish you the best!

Plan it quick! The end of year is coming and your insurance and deductible start over cone Jan 1 2013. I really hope I get scheduled for nov or dec. My out of pocket is gonna be $200. If I get it done next yr with will be $3000.00. I was told being on phentermine through previous weightloss attempts was good enough and my 3 month weightloss requirement was waived. I wish you the best!

Oh yeah!! Good reminder!!! I was going back & forth on whether to go after the holidays because I didn't want to be obvious with family and stuff, BUT YOU JUST SEALED THE DEAL FOR ME!!! If possible I want to go 1st week of Dec.

Wait, they waived the fee b/c you were on Phen?? You didn't have to prove co morbs either? When was your consult? Sorry for all the questions!! Lol

My fee wasn't waived...just the bcbs requirement for the 3. Month pre op weightloss was waived. My Advocate said my records from a weightloss clinic I went to a year ago where I was prescribed phentermine was acceptable. So now its just the psych eval and nutrition visit. I've already done the blood work and ekg in office.