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

Anyone have BCBS insurance?



Recommended Posts

I was told I have to do 6 months of weight loss consultations, along with a few others test to get approved for the surgery. My BMI is under 40. I am going through True results Houston. Anyone have the something different told to them?

Share this post


Link to post
Share on other sites

I have bcbs anthem. I had a bmi of 40 and I did not have to do the 6 mo weight loss consultation, not sure if it was because I was already banded that they knew I had been trying or not. I did have to have I think 3 test done before being approved.

Share this post


Link to post
Share on other sites

I have BCBS ppo of MA and was told I don't have to do the 6month diet, I have a BMI of 41 with no other comorbilitys.

Share this post


Link to post
Share on other sites

I've got BCBS Blue Choice and also waiting 6 months from start of process. Was told this was because I had not done a full 3 months on another weight-loss program within the last year. BMI 42, but told that wasn't issue, unless I go below 40 without comorbidities--then surgery could be denied.Taking the time to slowly get used to the upcoming changes and starting to tone up so everything doesn't hang later on!

Share this post


Link to post
Share on other sites

I have BCBS Blue Care and they won't cover a dime of my surgery :(

Share this post


Link to post
Share on other sites

I have BCBS EPO of Texas and I had to do 3 dr visits with my PCP and then it paid 100% of my surgery since I had already met my deductible for the year. But I also have 9 Co-Morbidities and my BMI is 42.8. My Severe sleep Apnea is what got me thru.

Edited by mjfuller

Share this post


Link to post
Share on other sites

BCBS IL PPO - I had to do 6 months of classes and whatnot. But honestly, the classes and pre-op counseling was worth it to me. I actually took closer to a year when it was all said and done (mostly due to my own scheduling and then towards the end the surgeon's schedule). My BMI was high enough and I was diagnosed with Type II diabetes, so there was no issue with approval.

With BCBS, it really depends on the plan your job picks whether you have to go to classes or if it gets covered at all. I had already met my deductible, but my plan still had an out of pocket maximum I had to pay.

Share this post


Link to post
Share on other sites

I worry when I read about insurance denying other people because they have no "Documented" weight loss attempts.

Of course like everyone else I've been on numerous diets, But none of them were documented other then Weight Watchers but when I called to get them to sign over papers that I attended meeting's they told me they couldn't find me in their system anywhere (Figures). So I'm relying upon a few medical records I found, Some from childhood documenting my weight gain, Another from when I was 11 (I was 166lbs then) and I was sent to a Dietician for my high cholesterol and the last from 2008 (188lbs) when I had my gall bladder removed, In the hospital records it says "Patient states she's on a diet" (Weight watchers at the time).

I'm hoping for approval, wish me luck!

Share this post


Link to post
Share on other sites

I have Blue Cross Federal. It paid well and I only had to do 3 months before my surgery.

Share this post


Link to post
Share on other sites

I have Blue Cross Federal. It paid well and I only had to do 3 months before my surgery.

Share this post


Link to post
Share on other sites

I, too, have BCBS but it's thru Michigan even though I'm in Missouri. I am currently in month 4 of my 6 months supervised diets. I can't go below BMI 35 with the dieting or I was told they would deny me. So, I am slowly losing and like others have said just learning the new way of life. Trying Protein powders, but not buying too many because that can change after surgery. Also made a list of the month before to use a small plate for portions, drink plenty of Water, using a food diary each day, exercise (going to begin walking) and Vitamins. It seems it's taking forever, but I know it is best for me. My surgeon will submit my documentation the end of July with my 6th weigh in and then ... we shall see.

Share this post


Link to post
Share on other sites

I have Horizon BCBS of NJ and they were awesome ( I never say that about any insurance company lol)

From what I have heard, they are the easiest to approve WLS.

I had to do a 3 months with the nutritionist, letter of medical necessity/ weight history from primary dr. and the psych evaluation and I was approved in a week with no issues.

My primary did have me at a lower weight last year, idk if that may have helped. They did not require documented weight loss programs from me.My BMI is at 41. Wish you the best & hope you are able to get an easy approval.

Share this post


Link to post
Share on other sites

I have BCBS of Michigan too, I had nothing to meet for them. They have been paying for sleep apnea supplies for the last 8 years, lots of heart tests last year, BMI of 60. The surgeon's office submitted before I even had the tests done by the cardiologists, new sleep study, etc. and it was approved while I was still waiting for the appointments. They are very happy ... I was costing them a lot of money a year, they can pay for this and hopefully all the problems will melt away thus return on investment is very nice!

BTW, they approved me in March the only reason I'm waiting for my datiwas my surgeon was booked up with the earliest date of July 1.

Edited by SusinMichigan

Share this post


Link to post
Share on other sites

I'm going thru True Results in Houston to get my sleeve. I have insurance with BCBS Illinois. My BMI is 40.1. They never mentioned that I ha to go thru consultation. I'm schedule to have my EGD on June 26th and hope to have my surgery soon after.

I was told I have to do 6 months of weight loss consultations, along with a few others test to get approved for the surgery. My BMI is under 40. I am going through True results Houston. Anyone have the something different told to them?

Share this post


Link to post
Share on other sites

I have bcbs and as long as my pcp documented that I came in and talked about my weight bcbs accepted that towards my 6 months. For actually 8 months I went to him and tryed diet pills and discussed diet and exercise. So when I decided to get wls it was already done. Good luck to you!

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

    • BeanitoDiego

      I changed my profile image to a molecule of protein. Why? Because I am certain that it saved my life.
      · 0 replies
      1. This update has no replies.
    • eclarke

      Two years out. Lost 120 , regained 5 lbs. Recently has a bout of Norovirus, lost 7 pounds in two days. Now my stomach feels like it did right after my surgery. Sore, sensitive to even water.  Anyone out there have a similar experience?
      · 0 replies
      1. This update has no replies.
    • Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
      · 0 replies
      1. This update has no replies.
    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
  • 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

    ×