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Insurance BCBS of IL



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I went to my primary care dr and they submitted to my PCP provider for a referal for the lap band surgery. They came back stated that I need 12 month supervised diet. I called and they told me that this can be by passed if my dr. thinks it is nessecary. Is this true. Not to sure what my Dr. submitted because they have never had to do this for anyone. At least that is what they told me.

Can anyone help. Has anyone had problems with BCBS of IL HMO

Thank you

Amber

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My doctor said that BCBS is actually harder to get approved then even medicaid!! They said that it used to be 12 months, but that BCBS has been working on making it 6 mos. like the other insurance companies.

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They wanted the supervised diet from me too. I have Anthem Kentucky Bc/Bs so I just self paid. I got tired of waiting and jumping through they're insurance hoops. Good luck. Hope you get approved soon.

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I heard if you use a preferred Bariatric surgeon and go thru the HMO site that this surgeon is contracted with, then BC/BS is the easiest. I have 2 friends that have BC/BS and both saw Dr. Lehmann and Joyce in Joliet IL. Both had the surgery within 3 months of starting the process.

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I had to be on a supervised diet for 12 months and while it really stunk, it also gave me time to really think about what I was doing and how it would change my life. Now, with surgery being 4 weeks away, I'm just anxious.

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I have BCBS of IL PPO and I only am required to have a six month commerically based diet. I used Jenny Craig. Have you asked your dr to by pass that process? Would he/she do that for you? Good luck! My paperwork was submitted this last Friday, hopefully mine goes in with no problems, I had everything they asked for!

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When I first started, it was a 12 month diet. In the meantime, there have been some changes, but that was after the fact for me.

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Yeah Diva - it seems that everyone has something different told to them. I had called the BCBS IL office and they said that it needed to be commerically based for six months, I also pulled up the website and printed off the long manual for the bariatric surgery and it lists everything out for you. Have you already been banded? Did you have any problems with the insurance going through?

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Poohlvr, I have not been banded yet...my 1st consultation is 5/16. I am praying and sstepping out on faith that I will not incur any problems w BCBSIL....i want this so bad!!!!

I didn't know you could find the policy on line...I'll have to go poke around. I was going to request a copy directly from them.

Have you heard anything yet? WHen did you submit everything???

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I have submitted mine - It was received last Wednesday. They said that it has to go through review and then review by a dr. So - it will take 2-3 weeks. I am praying that it will be sooner though. I want it done before by 5-25 birthday! If you go to bcbsil.com and don't log in - go to procedures - then find surgery for the morbidly obese and then you can print it from there. I am going to go back and try what I typed in, hopefully I got it right! If not I will repost!!! Good luck!

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Ok Diva - I was wrong here are the step by step directions to get there - let me know if you can't find it!

Go to bcbsil.com - don't log in

click on the providers tab at the top of the page

then click on medical policies (on the right side of the list)

click on I agree at the bottom

Click on view all active policies

then on page 15 of 18 you will find SURGERY FOR THE MORBIDLY OBESE

and you should be able to view it there! Good Luck! I hope that all goes well and quickly for you!!!

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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.

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    • 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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