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Federal Blue Cross Blue Shield requirements



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I have standard Federal Blue Cross Blue Shield in Arkansas. I have met all my requirements, have BMI of 42 with co-morbities of obstructive sleep apnea and high blood pressure. Have completed all my prerequisites except I have one more weigh in on Oct. 11 to complete the required supervised weight loss. Have pre-op appointment on Sept. 30 and gastric bypass scheduled for Oct. 20. Here's my question... the insurance says must have "diagnosis of morbid obesity for a period of two years prior to surgery." The year 2013 is not a problem but I don't know if they will count 2014 since the year is not finished out. If I can have my surgery before the end of the year it will not cost me anything because we have met our family medical stop loss. I was not sick in 2012 nor was I due for any check ups (remember the insurance requirements now where you don't have to get an annual pap smear, mammogram, etc.). My surgeon's coordinator said find a late 2011. I found one in December but my BMI then was only 33.9 instead of the needed 35. In early 2011 it was even lower, but I found in 2010 the office visit to the cardiologist where I exceeded the 35 BMI and he put me on a diet and I had lost some weight so that is why it was not the needed BMI in 2012. Do you think they will still approve me? It doesn't say it has to be two consecutive years so I do have two prior years, three if they will count 2014, since 2010. My surgeon's coordinator is going to call and see, but I am on pins and needs waiting for an answer.

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Did you go to any weight loss clinics? If so go get copy of yourrecords. I visited2 different clinics trying phentermine so i went in person to get copies for as long as 2 previous they just like to see you tried losing before hand. If you dont have that maybe they will use 2014 for your records.

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    • LeighaTR

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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.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • 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.

    • CaseyP1011

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