Jump to content
×
Are you looking for the BariatricPal Store? Go now!
$99 Yearly Supply Alert! 🎉 "1 per Day!" Bariatric Multivitamins

BCBS - What are they thinking?

maryb

By maryb, in Insurance & Financing

Recommended Posts

dpingl    0

dpingl
Posted

AFter reading some of these, I really am wondering if I am REALLY approved. I got a VAGUE letter ALSO stating as follows:

We have completed our review of your request for coverage of LAPAROSCOPIC GASTRIC BANDING under the Yellow Roadway Corporation Benefit Plan. Base o the information reviewed, we are pleased to inform you that coverage is avalible. All covered services are subject to screening for allowable charges.

Its goes on to now that this letter does not guarantee payment etc...??

Does that sound as if I am approved? I have a meeting with my Surgeon TOMORROW, I am excited and nervous!

Share this post

Link to post
Share on other sites

wantlapband    0

wantlapband
Posted

dotofoz,

I decided to go to the doctors office psych. They use the same one. I went to mine first since he has known me for a few years..but he wrote nothing about WLS...it was a general 3 letter that was so impersonal.

I go to day to see the psych.

I'm worried about my insurance carrier BCBS Anthem (nh)...I hope they approve me, the paper work gets sent in after this visit.

Share this post

Link to post
Share on other sites

wantlapband    0

wantlapband
Posted

AFter reading some of these, I really am wondering if I am REALLY approved. I got a VAGUE letter ALSO stating as follows:

We have completed our review of your request for coverage of LAPAROSCOPIC GASTRIC BANDING under the Yellow Roadway Corporation Benefit Plan. Base o the information reviewed, we are pleased to inform you that coverage is avalible. All covered services are subject to screening for allowable charges.

Its goes on to now that this letter does not guarantee payment etc...??

Does that sound as if I am approved? I have a meeting with my Surgeon TOMORROW, I am excited and nervous!

I hope it is an Approval letter! YEAH..keep us posted:)

Share this post

Link to post
Share on other sites

dotofoz    0

dotofoz
Posted

:bandit

Wantalalpband: Well, let me know how the visit goes, I wish you the BEST! I don't think these ins. cos. realize the mental torture they're putting us thru while we have to play their games! Oh btw, is your anthem fep? Mine is.

Share this post

Link to post
Share on other sites

officegirlblues    0

officegirlblues
Posted

Hey everyone. I have BCBS of Alabama and they do NOT cover the band. They will cover gastric bypass any time but not the band. :) I know. Doesn't make sense to me either. I've been trying for over 3 years to get the band and the doctors here won't even file it anymore. I've had one actual denial and I've seen a couple of different doctors and they all say there is no point in filing. BCBS of AL considers this surgery investigational.

I've written to the State Insurance Board and basically what they said was that each BCBS is different. Alabama chooses not to cover it for whatever reason and there is not a whole lot that can be done about it. All of the states around Alabama cover it so we're hoping maybe it will trickle down to Alabama eventually. Unless you have a kind of self-insured BC plan for a very large company you are just out of luck. Frankly, I'm getting tired of waiting and am considering just going ahead and having the bypass done.

Congratulations to everyone that has had it approved.I think its great and I am so happy for you! :clap2:

Hope

Share this post

Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
Go To Topic Listing Insurance & Financing

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • LeighaTR

      LeighaTR

      Four days post surgery. I am sipping as fast as I can and getting NO WHERE near the goal of 60 - 80 grams of protein or the 64 oz of liquids. I just feel FULL. I don't know if it can still be the gas build up (I would think by now that would be gone) but it is a struggle to drink. And so far I have not had the nausea or spasms and don't want to wander into that territory by pushing too hard with liquids. I about passed out today as it was my most "strenuous" day. Went from second story to basement for shower and I was sure I was going to pass out. Looking back on my last few days I have had a total of less than 1000 calories. Am I just not getting enough nourishment in me? Once again a friday where I can't get ahold of the doc until Monday rolls back around so I am hoping maybe someone here has some experience on how to keep energy going. I do have fibromyalgia too and that may be where some added fatigue comes into play. How did you all fair with the goals the week after surgery?
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Doughgurl

      2 days until I fly out to San Diego to have my Bypass Surg. in Tiajuana Mexico. Not gonna lie, the nerves are starting to surface. I don't fear the surgery itself, or the fact that I'm traveling alone, but its the aftermath that I'm stressing about the most, after this 8 week wait. I'm excited to finally be here, but I am really dreading the post surgical chapter. I know its going to be tough, real tough and I think I'm just in my head to much now that the day i here. Wish me luck, Hopefully I'm one of the lucky ones, and everything goes smoothly. Cant wait to give an exciting update,. If there is anyone else have a June bypass or even a recent one, Id love to have someone to compare war stories with. Also, anyone near San Antonio Tx? See ya soon with the future me. 💜
      · 1 reply
      1. Phil Penn

        Phil Penn

        Good Luck this procedure is well worth it I am down to 249.6 lb please continue with the process..

    • LeighaTR

      LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

        Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

      2. Doughgurl

        Doughgurl

        Thank you so much for your well wishes. I am hoping that everything goes easy for me as well. We don't eat out much as it is, so it wont be too bad in that department. Thankfully. Also, I hear you regarding your back and feet!! I'd like to add knees to the list. Killing me as we speak! I'm only 5' so the weight has to go. Too short to carry all this weight. Menopause really did a doosey on me. (😶lol) My daughter also lives in Houston. with her Husband and my 5 grand-littles. I grew up in Beaumont, so I know Houston well, I will be sure to keep in touch and update you on my journey. I may need some advice in the future, or just motivation. Thank You so much for reaching out, I was hoping to connect with someone in the community. I really appreciate it. 💜

    • 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. LeighaTR

        LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    Bariatric Forums

    For Patients

    Health Professionals

    Search Surgeons

    Bariatric Surgeons: Want to research a weight loss surgery surgeon? Enter their last name below to start!

    ×