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BCBS Federal of SC



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Hi,

just thought I would pop in and update anyone who is trying to find an answer from HIGHMARK BLUE CROSS BLUE SHEILD ADMINISTRATOR FOR

Alcoa plant in Ferndale Wa.

I just got the big answer that in order to apply for the insurance, I would have to meet all the comorbidities (no problem) be over 50 bmi for the VSG, (no problem) ...AND a 6 month Dr, assisted monitored diet to prove how I lose weight!!

Now, does it make sense they just payed 42.000 to replace my right hip due to osteoarthritis and if I don't get the weight off quickly, will end up having to

do my left hip too?

I can't beleive that none of the weight loss from Jenny Craig, weight watchers, nutrition center etc. count towards proof!

If I was an alcoholic, drug addict, they would spend thousands helping with that issue.

If I wanted viagra, yep they would cover that....

Hummmmm, guess that's how it goes!!

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@AKMama.... Yes, I was approved for the sleeve on the first try. Last year they were denying people left and right but did approve on appeals, but this year, since it's no longer considered experimental, they are more willing to approve you, as long as you have ALL of their requirements covered. You see, I thought I would be denied on my first try because I didnt have a BMI of 40 or more for longer than 2 consectutive years. I actually gainned weight in order to qualify for this surgery. But since I was between a BMI of 36-38 they considered that obses and approved me. Mind you, I had to do the 3 month supervised diet and all the other requirements too though.

Thanks for the information, I am in Alaska and no one up here even does the Sleeve procedure. So I am going down to Washington to Puget Sound Medical Center. I keep a BMI of around 40 to 41. I have sleep Apnea, bad knees, borderline high Blood Pressure and my feet look like sausages. So I'm hoping that they will accept me. So how do you get away with 3 months diet and not 6months? Do most get their Dr. first or get approved by the insurance?

Thanks again,

Lara

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My insurance plan only required a 3 month supervised diet!! Thank goodness! As for the process, you'll need to find a bariatric doctor who's in your network in Washington, then make your appointments with him first. Once you've done the supervised diet, whether it be 3 or 6 months, then they forward all your paperwork to your insurance company for approval. They compile all the documentation, but remember, you'll need 2 years of proof (medical records) that you've been 35+ BMI for those 2 years.

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ASHLEY!!!!! YOU DID IT!!! I'M SO HAPPY FOR YOU!!! WOW... JULY 8TH? THAT'S JUST AROUND THE CORNER!!!!!! OMG, so so so Happy for you!!!!!!

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I have BCBS-Fed n Ca and I was approved on the first try!!! It took only 3days for them to approve me with a BMI of 41.7

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Thank you for sharing about yor BCBS-Fed approval. 3 days...that's awesome!!

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    • 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

      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

        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

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
    • 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!!
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    • bellaamey

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