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BCBS FEDERAL BMI requirements for sleeve



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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!

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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/

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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

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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.

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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!!

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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.

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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

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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?

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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.

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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,

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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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