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Do you have BCBS Insurance?

Diamond-n-the-rough

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Diamond-n-the-rough    0

Diamond-n-the-rough
Posted

I was wondering for those of you who have BCBS insurance if you had to get the Gastroscope to check for Gastritis? And if so did you have to have the condition for BCBS to accept you? My doctor made it sound like my insurance company which is BCBS of IL requires you to have the condition before they will pay sounded a little weird to me...

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TexasT    99

TexasT
Posted

I have BCBS of Alabama and they don't cover any type of WLS. I was self-pay so I didn't have to do that procedure. Each BCBS group is different.

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ThatDudesMom    13

ThatDudesMom
Posted

I was wondering for those of you who have BCBS insurance if you had to get the Gastroscope to check for Gastritis? And if so did you have to have the condition for BCBS to accept you? My doctor made it sound like my insurance company which is BCBS of IL requires you to have the condition before they will pay sounded a little weird to me...

No help here....I have BCBS, but it is basically the only insurance in Kansas that doesn't cover ANYTHING related to weight loss.

I hope all goes well for you!

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hopeandfaith    6

hopeandfaith
Posted

I have BCBS of OKLA and they didn't require that. I only had to go to a weight management doctor for three months. They just started covering the sleeve! I'm getting sleeved on TUESDAY January 11th!!!!

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FlyGirl    18

FlyGirl
Posted

BCBS of GA didn't require that. I had to be over 40 bmi or 35 bmi with two morbitities like high bp, cholesterol, sleep apnea, etc.

Good luck, I hope you get approved! :)

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myrori    55

myrori
Posted

I have Blue Cross Blue Shield Il and they required a BMI of 35 and a co morbidity. I did not have to have a scope.

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KabinKitty    11

KabinKitty
Posted

I have BC/BS of Ohio which just started to cover the sleeve in Nov of 2010. I just got approved last week and I'm scheduled for surgery on Feb 2, 2011.

Like someone else said, different surgeon's require different tests. My surgeon requires all his weight loss patients to have an upper GI. Some others don't, but do require an endescope.

I truly believe that BC/BS is going to cover the sleeve in every state some day. Some company administrators put in exclusion (which they have the right to do) to exclude coverage for any WLS. I feel so blessed that my groups administrators didn't do that....yet! That is the reason I feel I HAVE to get the surgery now, before it get excluded.

Best wishes to you on your surgery!

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HollyW    5

HollyW
Posted

I have BCBS of IL and I had to do 3 months of dieting with my PCP, nutrionist visit, Psych evaluation was required through my insurance. My surgeon wanted the sleep study and EGD. My insurance covered everything without question. Of course even though we have the same insurance, all policies are written differently.

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Kya    0

Kya
Posted

I was wondering for those of you who have BCBS insurance if you had to get the Gastroscope to check for Gastritis? And if so did you have to have the condition for BCBS to accept you? My doctor made it sound like my insurance company which is BCBS of IL requires you to have the condition before they will pay sounded a little weird to me...

I have BCBS of Illinois, but I wasn't told that was part of a requirement for insurance. Wierd.

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BrittanyAnn1    2

BrittanyAnn1
Posted

I was wondering for those of you who have BCBS insurance if you had to get the Gastroscope to check for Gastritis? And if so did you have to have the condition for BCBS to accept you? My doctor made it sound like my insurance company which is BCBS of IL requires you to have the condition before they will pay sounded a little weird to me...

I can assure you for BCBS of IL you do not have to have that procedure done. I have BCBS IL and I work for them!!!

I am sure it is something that your doctor wants you to do to be on the safe side.

My doctor required a whole slew of things and BCBS paid for it all with no questions. If you need any help with your insurance questions feel free to contact me.

Brittany

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NikkiRose    0

NikkiRose
Posted

Hi, I have BCBS of Michigan and no I didn't have to have any pre-condition. My surgeon's office made it sound like they didn't even need "pre-approval"...just needed to confirm that the procedure was covered and that I had dont everything required. They must have been right because my surgery date was set rather quickly. Good luck!!!

I was wondering for those of you who have BCBS insurance if you had to get the Gastroscope to check for Gastritis? And if so did you have to have the condition for BCBS to accept you? My doctor made it sound like my insurance company which is BCBS of IL requires you to have the condition before they will pay sounded a little weird to me...

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Susanne    32

Susanne
Posted

BCBSMI does not do pre-approval, they won't give you anything written that they'll cover it.

I am in Grand Rapids, where are you?

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Brother J    11

Brother J
Posted

My BCBS did not pay for WLS. It could be the type of plan I purchased. You'd think paying about $9600 a year for insurance, it would include WLS.

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gotamakeachange    7

gotamakeachange
Posted

I have BCBS of MI PPO, they started covering the sleeve on November 1, 2010 and I was approved on November 8, 2010 within 24 hrs of my paperwork being submitted. No I did have to do a gastroscope, but I also didn't have a supervised diet. The insurance coverage is different state to state and job to job. Good Luck

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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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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
      1. This update has no replies.
    • 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/
      · 0 replies
      1. This update has no replies.

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