I'm trying to appeal to BCBS of Oklahoma for the lap band & am interested in BCBS's coverage of it in other states...anybody out there know???

I have BC&BS of IL. they cover 80% if you have a BMI of 40 or above and a Dr. letter. They also want 5 years worth of weight records from your family physician and a good thyroid test. Hope this helps.

JP

I have BCBS of Iowa anf we are preparing to submit to insurance either today or tomorrow.:faint: I have done all pre op testing and have found that my BMI is 46.2, I have sleep apnea, gerd/acidreflux, and I have completed yet another medically supervised diet. I have done supervised in the past but was told that BCBS of Iowa likes them to be done within 2 years prior to applying for surgery. My insurance plan does cover the surgery at 80/20 with an out of pocket max of $2,000 per year in which has been met with other appointments this year for other issues so the surgery would be 'free' :heh:. My question is this. With what I have told you about the co morbidities I have and my BMI do you think I will be approved? I know no one can give me the answer per say but I am asking for your opinions. I am just setting here restraining myself from phoning the insurance already and asking if they got the paperwork yet and what do they think-LOL I know I am being nerotic (sp?) now. Just wanted to hear others ideas on this.

BTW the surgeons office told me that BCBS is one of the easiest insurances to get to approve and to work with. Hope this proves true in my case as well as others.

Thanks for listening to me ramble. Now the wait begins-:frusty::phanvan

I have BCBS of Iowa anf we are preparing to submit to insurance either today or tomorrow.:faint: I have done all pre op testing and have found that my BMI is 46.2, I have sleep apnea, gerd/acidreflux, and I have completed yet another medically supervised diet. I have done supervised in the past but was told that BCBS of Iowa likes them to be done within 2 years prior to applying for surgery. My insurance plan does cover the surgery at 80/20 with an out of pocket max of $2,000 per year in which has been met with other appointments this year for other issues so the surgery would be 'free' :heh:. My question is this. With what I have told you about the co morbidities I have and my BMI do you think I will be approved? I know no one can give me the answer per say but I am asking for your opinions. I am just setting here restraining myself from phoning the insurance already and asking if they got the paperwork yet and what do they think-LOL I know I am being nerotic (sp?) now. Just wanted to hear others ideas on this.

BTW the surgeons office told me that BCBS is one of the easiest insurances to get to approve and to work with. Hope this proves true in my case as well as others.

Thanks for listening to me ramble. Now the wait begins-:frusty::phanvan

I have federal bcbs and was approved the same day as my papers were submitted. My BMI was 54, with no co-morbidities.

good luck!!!

Hi, Yes, I am having problems. I have been researching for 2 years and as of Jan. 2007, my insurance finally decided to join the band wagon of allowing the Lap band surgery.. REegence BCBS. Boy! was I excited!!!! I made the appointment for my seminar ( traveled 4 1/2 hours, spent a few days) and talked to the surgeon. He gave me paperwork to fill out, Got home and he accepted me as a patient. First thing he advised was to call my insurance company and see if it allows the surgery. Guess What? I have an Exclusion in my policy. So, here I am trying to find out what to do now. How can I even pay for all the testing they want if my insurance says they will not pay for anything to do with Obesity. Not even the testing. I am so disappointed and confused and feeling so hopeless. I do not know how to proceed from here.

I have BC&BS of IL. I have been told they will cover 80% if you have a BMI over 40 a good thyroid test a psych. consult. I am still waiting my paper work was received on 5/23/07. It is in the reviewing process. God only knows how long this may take. Good luck to you.

JP

I checked with BCBS of AL, which is the ins. that I have now, and as of April 28th, 2007, they will now cover lapband procedure and not just the by-pass provided that you follow the guidelines that they have set forth.

The main one seems to be going to an approved method of trying to lose weight for 6 consequtive months no less than one year prior to request for surgery. This can be 6 visits to your family physician, once per month documenting what you are doing, etc or to something like LA Weight Loss. It cannot be Weight Watchers, online weight loss sites, etc.

I am thankful that this has now been approved and that as long as I follow their guidelines (which are almost identical to the by-pass ones)

because I am about halfway thru the process now and am truly looking

forward to being able to have my surgery in the fall.

Please check with your BCBS provider and they can send you the new ruling dated April 28th, 2007.

Linda

I am in Reno, NV. It took 8 weeks to get the approval and I had to travel to California for BCBS to approve it but I was approved on the first try.

I have BC/BS of Illinois. I had to have 5 years of medical records, a psychiatric evaluation, sleep apnea study and 6 months worth of consistent supervised weight reduction proof. After I got all of that I needed, it was submitted to the insurance company and 6 days later I was called by the office and told I was approved. My insurance pays 100% which is unheard of but that's one of the perks of the company I work for. Thank goodness. I am scheduled for May 14th. I can't wait. It has been a long wait but well worth it.

I had my lap aug 2007 started 243lbs now 165il and going for a fill this thrus and getting ready to start weight training email me at traceylemon@prodigy.net if have any questions:wink2::cry_smile::thumbup::crying:

I have Empire BCBS. My BMI is 49 and I have mild sleep apnea. I was approved about 15 days after the surgeon's office submitted the request. My co-pay for the surgery is $250, in addition to co-pays for the surgeon, nutritionist and therapist.

it's ok because the surgery is worth it:thumbup:

I've noticed people saying they check their insurance approval status for bariatric surgery online. Can anyone tell me how to do it? I have BCBS FEP.....