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Bcbs il diet requirements



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I need some advice. I called my insurance bcbs il and was told they saw no requirement for 6 months of documented diet (my bmi is 45). Has anyone been approved recently(2014) and if so did you have to do the 6 month diet first? Also when you paid your out of pocket did you have to pay the surgeon or physician? Sorry for the questions I'm new to this and anxiously trying to get my doc appointments in ☺

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I haven't been approved yet (finishing up requirements), but I have BCBS IL and you're right, no pre op diet requirement. I just have to follow whatever my surgeon requires. Also need nutrition counseling and psych eval. Your BMI is high enough, too. (You need a BMI of 40 or 35 with co-morbidities). I have been paying my co-pays at doctor visits but I don't know how much the surgery out of pocket will be. Sorry if that's not too much help

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Thanks so much for your response. I finish up my appointments (psych,dietician, pulmonology and cardiology) the 30th. So glad to hear you didn't have to do the 6 month diet. I was getting worried after reading about other BCBS holders that got denied because of it... Im just so ready to get this done!

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My out of pocket portion was met through all the pre-op blood work, x-rays, etc, so I don't think I had to pay anything on surgery day. Now I just pay my office visit copay when I go in for fills and checkups.

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I have BCBS and they required 4 months of supervised dieting with doctor. Depends on the employer plan

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I have BCBS of IL and they require 6 months of nutritional counseling. I went to my pcp and got documentation, then I went to the surgeon's nutritionist for two months, and not I'm doing my last 4 visit with my PCP. The office is leery about me switching but that doesn't make sense. The visits must be monitored by a physician and a physician is not a nutritionist and vise versa. My last visit is March so we'll see if I get approved, which I doubt. My highest BMI recorded was 40.38 and no medical conditions.

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neither me or my wife had to do a supervised diet but they did make us both see a nutrisonist 1 time but let me tell bcbsil was a pain in the butt for me. my wife was denied and the dr was able to get it approved me i had to take it to arbitration before i was aprroved. i met several of the requirements sleep apena high blood pressure ostreo artritis and a bmi or 38.7 and still got denied the nice thing was that my drs office took care of everything i didnt even need to make a phone call

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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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