BCBS FEDERAL BMI requirements for sleeve

[artsy298 0]

I have BCBS federal in NC and I have called them twice to find out what the Bmi requirements are for the sleeve. I just get told to look in my book which tells me nothing specific. Can anyone tell me what the sleeve BMI must be for the sleeve and how long it must have been that high. Thank you I am going nuts!

[tj.whoami 0]

Hi Artsy. I'm new to this site; in fact, this is my very first post. I'm just beginning to look into the requirements for surgery as well, so I'm perusing the forums to gather as much information as I can. I found the information at the link below concerning federal bcbs requirements. I hope this helps you out.

http://obesitycoverage.com/bcbs-federal-employee-program-and-florida-blue-weight-loss-surgery-requirements/

[kriketa68 3]

I have BCBS MS for state and school employees so I'm thinking that its not that different. When I had my sleeve last month the BMI requirement was 40 and above and you must have been there for at least 2 years. There was a thing about you could be 35 BMI if you had 2 chronic co-morbiturates. The surgery center that I had my sleeve done at knew all the requirements that was needed for my insurance. If you have found someone to do your surgery you may want to call their insurance dept. to see if they can tell you.

Kristi

[Kking1205 21]

I have bcbs federal basic .....I had the sleeve in February. 40 or higher BMI . Or two or more health issues do to being obese example....diabetic , sleep apnea , high blood pressure ect.... You must have two years of weight documentation and six months of weight management with a physician.

[peteyrulz 82]

I have BCBS fed in Virginia. (standard plan) From what I understand your BMI must 40 or >, or it can be between 35 & 40 with 2 co-morbidities. I have to be in 3 month med supervised plan and have 2 yrs weight history. HTH!!

[peteyrulz 82]

Artsy I forgot mention....I got the same answers when I called BCBS. I wanted to say "Hey Lady, I Can Read the Book, Too!" Lol.

[artsy298 0]

Thanks to all of you for responding. I have made an appt with Frye in Hickory after talking to them for about 30 min. Sounds like I should qualify and hopefully I can get this ball rolling. Thanks again

[mamaofmatthew 51]

I have bcbs federal basic .....I had the sleeve in February. 40 or higher BMI . Or two or more health issues do to being obese example....diabetic , sleep apnea , high blood pressure ect.... You must have two years of weight documentation and six months of weight management with a physician.

I too have BCBS Federal, I only need 3 months doctor visits...was the 6 months listed in your benefits book?

[southern_sweetie 21]

I also have BCBS Federal. I was told you have to have a BMI above 40 with no co-morbilities and if you are 35- 39.9 you have to have 2 co-morbilities. I am also having to do a 3 month weight loss program with my PCP. I also had to have 2 years of doctor's notes with a documented weight. They only needed one from each year.

[nrzjago 0]

I have two years worth of weight records from my PCP however my weights aren't over BMI 35. Currently I am at 35 with comorbidities- the Bari doc said I need to submit photos when she dub,it's request for approval since my weight records aren't Hugh enough BMI. Family history is extensive cardiac issues -HTN- apnea- you name it . My current diagnosis - HTN- borderline hgba1c- depression-anxiety- osteoarthritis-heel spurs-obesity(not morbid) lost weight with weight watchers 5-6 years ago- regained and then some. Any suggestions for my three month weigh in prior to submission of authorization request? I never take pictures- so worried that is not an option,