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Well... here we go!!

So I was one of those ppl who was about to submit to the insurance when BCBS of IL changed the requirements from 3 months to 6 months so I decided to just do a 6 month with my Dr. Well, yesterday was the final visit so it is gonna be resubmitted next week! I am so nervous that it won't go through... my BMI was just over 40 when I started so I should be fine, but I just want to know for sure!! Even though I can't have surgery till November because of work...

Wish me luck!!!

Glenna

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I was so worried about mine too! I have Kaiser and I read and re-read their requirements I know, 500 times. I met them and knew I was fine, but I was so sure I wasn't going to get to have my surgery. LOL

I am sure you will be fine. Our minds like to talk us out of things. You will be sleeved before you know it.

Hugs,

Kelly :)

I have BCBSIL too and my BMI was 35 with 3 of the c-morbidities. You should be fine with a 40 BMI although they use the BMI that was at the beginning of the 6 months of medically supervised weightoss. Start calling right away so you are informed. My first fie required additional information that was actually already in there but it was refaxed anyway by me and the surgeon's office and 5 business days later I had my approval. I have no doubts that you will have your approval soon!

So I was one of those ppl who was about to submit to the insurance when BCBS of IL changed the requirements from 3 months to 6 months so I decided to just do a 6 month with my Dr. Well, yesterday was the final visit so it is gonna be resubmitted next week! I am so nervous that it won't go through... my BMI was just over 40 when I started so I should be fine, but I just want to know for sure!! Even though I can't have surgery till November because of work...

Wish me luck!!!

Glenna

I'm in the same boat as you regarding BCBSIL. I was ready to submit my paperwork when they changed from 3 to 6 months. I have just recently finished my 6 months and as of today am re-submitting my paperwork. Now it's time for the waiting game. :confused_smile: I wish you lots of luck! Please let us know when you get approve. (Think positive) We will be cheering for you. :cheer2:

Divis

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Quick update... the surgeon called & the Dr's office missed the August visit so they are resending it :( On a great side the notes look great with what she documented & she wrote a great letter stating that I was a great canidate for the surgery!! WooHoo!! Sending the ppk this week for sure...

Glenna

  • Author

Soooo.... I am trying not to be discouraged, however i am bummed. I got denied too by BCBSIL because the first month of my 6 month program with my PCP did not list my BMI. The first month I did the program was in April with a BMI of 40.8, then in May I was at a BMI of 39.8 so they considered the 39.8 the 'starting BMI' so I have to have the 2 co-morbidities. I am hopeful that when I have my PCP resend the note from April with the real starting BMI it will be approved since with a BMI of 40 I don't have to have any co-morbidities, but this is my worst fear... getting this far, getting this excited for nothing!

I have heard from some ppl on this forum that they were able to talk to the person at the insurance who is making the decision... how do I do that?? I was told today that I couldn't talk to the nurse!! Bummer... Does anyone have any advice??? I really want this done in November...

Thanks for listening, I was just hoping for better news :(

Glenna

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