Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Here we go! Would love some wisdom!



Recommended Posts

Ten years of weight creeping up and here I am-- with a BMI of 36 (go me!!) with 2 co-morbidities. Tired of losing and gaining the same 10 lbs five times a year, I decided to take a step.,,or rather a leap.

And here we are

8/29-- WLS seminar

9/11 -- first visit.

Have Anthem BC of CA so hope I get approved

And now I'm working though my list

Primary care letter of clearance -- check

Blood work-- check

Three years of 35 + BMI -- check again (another go me moment!)

Doing sleep apnea study tonight

To do:

Cardiac clearance (required if you're over 50.. And I'm 50 and 2 weeks.)

NUT appt

Psych eval ( wonder how that will go)

So I'm hopeful that I get this all one quickly and get approved ( holding my breath )

Anyone else out there with Anthem BC of CA? Any tips.

Oh and I'm an Alabama gal

Share this post


Link to post
Share on other sites

I have BCBS of Illinois and they required everything that you have listed above, plus a six month waiting period. You must see the nurse practitioner and dietician three times. Beginning, after 3 months and exactly six months. After the last visit at 6 months, with the surgeon, nurse and dietician the request is sent to BCBS for a final okay for the surgery. My office said that can take from a week to three weeks. BCBS has been great so far and paid for everything after my deductible was met. (Met early on by the sleep study). The time flies by. October 23 is my 6 months thank goodness.

Share this post


Link to post
Share on other sites

I have BCBS of Illinois and they required everything that you have listed above' date=' plus a six month waiting period. You must see the nurse practitioner and dietician three times. Beginning, after 3 months and exactly six months. After the last visit at 6 months, with the surgeon, nurse and dietician the request is sent to BCBS for a final okay for the surgery. My office said that can take from a week to three weeks. BCBS has been great so far and paid for everything after my deductible was met. (Met early on by the sleep study). The time flies by. October 23 is my 6 months thank goodness.[/quote']

Where do you live? I have the same insurance and none of those requirements. All they needed to submit was my Psyc eval, which I had done yesterday, and they submitted today.

Share this post


Link to post
Share on other sites

I have BCBS of Illinois and they required everything that you have listed above' date=' plus a six month waiting period. You must see the nurse practitioner and dietician three times. Beginning, after 3 months and exactly six months. After the last visit at 6 months, with the surgeon, nurse and dietician the request is sent to BCBS for a final okay for the surgery. My office said that can take from a week to three weeks. BCBS has been great so far and paid for everything after my deductible was met. (Met early on by the sleep study). The time flies by. October 23 is my 6 months thank goodness.[/quote']

Glad to hear the time flies. Now that I've made the decision, I'm ready to go. Sounds like you have more fiery hoops than me, but it's all good in the end, right

Share this post


Link to post
Share on other sites

Where do you live? I have the same insurance and none of those requirements. All they needed to submit was my Psyc eval, which I had done yesterday, and they submitted today.

The insurance criteria is determined by the contract your employer negotiates with the insurance company. I have UHC and my employer goes through Optima for bariatric services but another person I know has UHC and they do not use Optima and she had different criteria to meet than I do.

Good luck with your journey.

Share this post


Link to post
Share on other sites

I have the same insurance. They changed the requirements since I had my surgery, and now they require a six month supervised diet. The good news is that the surgery didn't cost me a thing. The only thing I had to pay was the $15 dollar copay for doctors visits, which added up to $45 for the whole thing for me. Good luck girl! :)

Share this post


Link to post
Share on other sites

I have Anthem BC/BS as well. But I'm in Georgia so I don't know if there's a difference. They approved me no problem or questions asked as long as I did everything they required.

Share this post


Link to post
Share on other sites

I have Anthem BC Calif Care and they were so fast with their approval. Like less than a week. No 6 month diet crap. Really, I chose the best insurance by accident. I had the choice between a few through work, and I'm so glad I chose Anthem. Good Luck!

Share this post


Link to post
Share on other sites

I have Anthem BC Calif Care and they were so fast with their approval. Like less than a week. No 6 month diet crap. Really' date=' I chose the best insurance by accident. I had the choice between a few through work, and I'm so glad I chose Anthem. Good Luck![/quote']

Lol. We have had the same insurance for years and its finally paying off. I think we spend like $600 a month for ours. At least I'm getting some good use out of it. Now I hope I can lose the weight and get my TT covered before anything changes.

Share this post


Link to post
Share on other sites

Good luck on your journey Mary!! We are on a similar time line in terms of dates!!!

Skinny, I also have BCBS if Il and didnt have to do the 6 month diet part just a psych eval and saw a Nut once and was submitted on Tuesday 9/17. I still have a ton to do pre surgery for the surgeon but I will be at least approved by insurance.

Share this post


Link to post
Share on other sites

I have Anthem BC Calif Care and they were so fast with their approval. Like less than a week. No 6 month diet crap. Really' date=' I chose the best insurance by accident. I had the choice between a few through work, and I'm so glad I chose Anthem. Good Luck![/quote']

Good to hear! I was thrilled to warn I didn't have to do the 6 month diet thing. I think we can all agree that dieting is not working for me.

Share this post


Link to post
Share on other sites

I have Anthem BC Calif Care and they were so fast with their approval. Like less than a week. No 6 month diet crap. Really, I chose the best insurance by accident. I had the choice between a few through work, and I'm so glad I chose Anthem. Good Luck!

I also have Anthem HRA too and they required exactly what you listed. I'm waiting for my surgeon's office to receive the info from my psych eval that was approved and my blood test results and then they can submit for approval to the insurance company.

Share this post


Link to post
Share on other sites

I also have Anthem HRA too and they required exactly what you listed. I'm waiting for my surgeon's office to receive the info from my psych eval that was approved and my blood test results and then they can submit for approval to the insurance company.

Hope you hear good news soon!!

I still have a few more steps but hope to get those super fast!

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

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Clueless_girl

      Losing my hair in clumps and still dealing with "stomach" issues from gallbladder removal surgery. On the positive side I'm doing better about meeting protein and water goals and taking my vitamins, so yay? 🤷‍♀️
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      I've hit a stall 9 months out. I'm not worried, though. My fitness levels continue to improve and I have nearly accomplished my pre-surgery goal of learning to scuba dive! One dive left to complete to get my PADI card 🐠
      I was able to go for a 10K/6mile hike in the mountains two days ago just for the fun of it. In the before days, I might have attempted this, but it would have taken me 7 or 8 hours to complete and I would have been exhausted and in pain for the next two days. Taking my time with breaks for snacks and water, I was finished with my wee jaunt in only 4 hours 😎 and really got to enjoy photographing some insects, fungi, and turtles.
      · 0 replies
      1. This update has no replies.
    • Mr.Kantos

      Just signed up. Feeling optimistic.
      · 0 replies
      1. This update has no replies.
    • Frugal

      Welcome to Frugal Testing, where we are committed to revolutionizing the software testing landscape with our efficient and affordable solutions. As a pioneering company in this field, we understand the challenges faced by startups, small to medium-sized businesses and any organization working without budget constraints. Our mission is to deliver top-notch testing services that ensure the highest quality of software, all while keeping your costs in check.
      Frugal Testing offers a comprehensive suite of testing services tailored to meet diverse needs. Specializing in different types of testing including functional testing, automation testing, metaverse testing and D365 testing, we cover all bases to guarantee thorough software quality assurance. Our approach is not just about identifying bugs; it's about ensuring a seamless and superior user experience.
      Innovation is at the heart of what we do. By integrating the latest tools and technologies, many of which are cutting-edge open source solutions, we stay ahead in delivering efficient and effective testing services. This approach allows us to provide exceptional quality testing without the high costs typically associated with advanced testing methodologies.
      Understanding each client's unique needs is fundamental to our service delivery. At Frugal Testing, the focus is on creating customized testing strategies that align with specific business goals and budget requirements. This client-centric approach ensures that every testing solution is not only effective but also fully aligned with the client's objectives.
      Our team is our greatest asset. Composed of skilled professionals who are experts in the latest testing techniques and technologies, they bring dedication, expertise and a commitment to excellence in every project. This expertise ensures that our client’s software not only meets but often exceeds the highest standards of quality and performance.
      Frugal Testing is more than just a service provider; we are a partner in your success. With a blend of quality, innovation and cost-effectiveness, we are here to help you navigate the complexities of software testing, ensuring your product stands out in today's competitive market. 
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      I have no clue where to upload this, so I'll put it here. This is pre-op vs the morning of my 6 month appointment! In office I weight 232, that's 88 lbs down since my highest weight, 75 lbs since my surgery weight! I can't believe this jacket fit... I am smaller now than the last time I was this size which the surgeon found really amusing. He's happy with where I am in my weight loss and estimates I'll be around 200 lbs by my 1 year anniversary! My lowest weight as an adult is 195, so that's pretty damn exciting to think I'll be near that at a year. Everything from there will be unknown territory!!

      · 3 replies
      1. AmberFL

        You look amazing!!! 😻 you have been killing it!

      2. NickelChip

        Congratulations! You're making excellent progress and looking amazing!

      3. BabySpoons

        So proud of you Cat. Getting into those smaller size clothes is half the fun isn't it?. Keep up the good work!!!!

  • 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

    ×