Hello everyone! Im trying to find more answers to all my questions and this seems to be the perfect place I guess first of all I am curious to know if anyone here is from Michigan and or has blue care insurance. I have heard many different stories from people I know about the requirements and everything leading up to qualifying for the surgery. I just got switched to blue care network from priority health and have to select a new Dr. I was curious if anyone had one they would recommend. Thank you!

I had to do 6 month weight management, EKG, lab work, exercise class, as well as psychological evaluation, as well as a 2 hour class regarding the surgery vitamins, measuring , and appropriate foods and reading material .Also I should mentioned that my surgeon program is one of excellence .

Good Luck on your journey. I have Tricare (Military dependent) and had to show 3 months of MD documented wieght management, which my surgeon told me about in December, even after I called the insurance and they said it was not required. Fortunately my doc is super supportive and used my October, November and December visits to document. I LOVE HER!! All I have left is my GI appointment on Monday, my last weigh in on Wednesday and my Phych appointment on Thursday and a support group meeting on Saturday. Then I play the waiting game for the surgeons office to ensure I have all my clearances and to submit to the insurance company. Keeping my fingers crossed that I can have surgery in January or early February. I am sooooo ready!!

I started the process in September, but the last 4 months have really gone by quickly, even though when I started it seemed like it would take forever!! The 6 months will go by quicker that you expect.

Good Luck on your journey. I have Tricare (Military dependent) and had to show 3 months of MD documented wieght management, which my surgeon told me about in December, even after I called the insurance and they said it was not required. Fortunately my doc is super supportive and used my October, November and December visits to document. I LOVE HER!! All I have left is my GI appointment on Monday, my last weigh in on Wednesday and my Phych appointment on Thursday and a support group meeting on Saturday. Then I play the waiting game for the surgeons office to ensure I have all my clearances and to submit to the insurance company. Keeping my fingers crossed that I can have surgery in January or early February. I am sooooo ready!!

I started the process in September, but the last 4 months have really gone by quickly, even though when I started it seemed like it would take forever!! The 6 months will go by quicker that you expect.

Wow busy schedule but so exciting! Well I just figure you have to start some where! Im fine with a wait as long as I know I am headed in the right direction better late than never right? Good luck to you!

How easy was it for you both to breach the wls topic with your Dr.? Were they supportive or did they think it was the "easy way"? How long did you have to talk about it before it became a possibility?

Actually i went to my appointment and my doctor was all for it! He did the referral with no questions. He was actually excited for me!

Hello

I have heard many different stories from people I know about the requirements and everything leading up to qualifying for the surgery.

Not from MI here.

Wouldn't it be wiser to call your insurance company and have them send you the requirements and costs?

Also, sometimes the insurance requires less than the Bariatric Center. In my area one center requires you to pay for educational classes at $50 a class while others require you to lose 10% once you are in their program. My insurance requires none of these things. I just had to reach the BMI to be approved for full coverage. Not even a referral by GP.

I did call my insurance, I now know all of the requirements per them and am going to a seminar on the 14th.. now I just have to figure out if it would be more practical for me to do self pay considering they only cover half. And then try to figure out if getting that much extra money is even feasible lol

I did call my insurance, I now know all of the requirements per them and am going to a seminar on the 14th.. now I just have to figure out if it would be more practical for me to do self pay considering they only cover half. And then try to figure out if getting that much extra money is even feasible lol

Did they have a lot of hoops to jump through?

I could never afford this surgery as private pay. I'm glad they loosened up on their restriction at my ins.

Hi,

I am from Upper Michigan. I have Blue Cross & Blue Shield, it took 2 letters from my doctor before they pre-approved me.

Jessicatcmi if I were you I would let them pay for what they are going to pay and fiancé the remainder , because we pay all that money toward insurance and rarely use it .

My information has not been submitted by my surgeon yet but I was approved prior to beginning this journey because I didn't want any hidden surprises .

My doctor was very supportive , how ever they were slow in probing all the documentations, I am glad that's tomorrow's my last visit is tomorrow but they are excited that I will be healthier and will be off all medications .

Awesome!!

Edited January 10, 201412 yr by ajustice

Actually i went to my appointment and my doctor was all for it! He did the referral with no questions. He was actually excited for me!

Ditto. I was at my wits end but after finding out my insurance would pay if I met the criteria I decided to talk to my PCP. He'd had patients with good results and thought I'd be a good candidate. He arranged for me to attend the informational seminar. When I told my endocrinologist about my decision he congratulated me and hugged me. He knew my surgeon and had nothing but the highest praise for the program. It helped me feel more at ease with my choice. :-)

Im still going to the seminar on the 14th and hope to walk away more informed. As for the money aspect of it I am willing to do anything to better my life, I am just afraid that I may fail or not have the results that I wanted and then feel guilty of using that much money.. but I know that many people probably have similar feelings and fear.