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hlpnhnds

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hlpnhnds    0

hlpnhnds
Posted

HI all-- this has been a very informative site. I have had my initial visit with my doctor. My psy consult, fitness eval and nutrition consult have been scheduled. My BMI is just over 40. I was wonder if anyone out there had BCBS and if they had any trouble getting approved.

Thanks:)

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Kat817    19

Kat817
Posted

Hi---welcome to LBT! I do have BCBS---it is BCBS of TX. And yes they made my life miserable!!! BUT---there are many, many different coverages of BCBS, and a lot of it depends on what exclusions your employer placed. It is impossible to advise you---the best thing you can do is call them. Take meticulous notes---when you called, who you talked to, what they say....and put on your tenny shoes, and get ready to jump through some hoops!!! The good news is...it is SOOOOO worth jumping through them!!!!

Each plan has different requirements. Mine consisted of 5 years of documented obesity, a BMI of 40 or 35 with 2 co-morbidities, and 12 consecutive months of a medically supervised weight loss program, with bi monthly nutritionist consults. My problems come in with the 12 consecutive months thing. I had done 10 1/2 months consecutively, and then was in a car accident, and required surgery. Due to that I missed my appointment in the 11th month, and rescheduled it for when I got out of the hospital...but it was over 30 days since the prior appointment, and they decided I had been non compliant. So they denied me...twice. It was a mess---I likely could have sued and won....I gave up, and self paid---with my settlement from the accident! But my SIL has BCBS, and she had no problems whatsoever! So it is a guessing game as to what your plan requires, and what clauses your employer added.

Make that call, and get the ball rolling---it is a great thing this band!!!

Good Luck!! Hang out with us---lots of people working to get approval---this site is perfect for support!

Kat

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hlpnhnds    0

hlpnhnds
Posted

Thanks Kat-- Mine is BCBS of NC and according to my booklet all that they require is a BMI of 40. My doctor asked me to get the last 5 years of documented weight and I am worried because they are at a BMI of 32-38. I guess I just need to give them a call

Thanks

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NVgirl    2

NVgirl
Posted

I have BCBS in Nevada and they couldn't have been any better! Paperwork was sent to them on a Friday and approval was given that very next Monday. 6 weeks till surgery!

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Go To Topic Listing Tell Your Weight Loss Surgery Story

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    • Alisa_S

      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

      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

        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.

    • CaseyP1011

      CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
    • KimBaxleyWilson

      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!!
      · 0 replies
      1. This update has no replies.
    • bellaamey

      bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
      · 0 replies
      1. This update has no replies.

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