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

BCBS of Michigan. Waiving the six months?



Recommended Posts

In the information given to me by the hospital I'm having my surgery through, it said that if your BMI is over 50 (mine is 59), Blue Cross Blue Shield of Michigan waives the six month dieting/wait period. Does anyone have experience with this? I'm getting BCBS of Michigan anyway, but I'm really hoping this wasn't misinformation.

Thanks a bunch!

Share this post


Link to post
Share on other sites

I was just oked today to have gastric sleeve and I have blue care network they just told me that they have to have a six month diet done with a nutritionist

Blue Cross Blue Shield of Michigan and Blue Care Network aren't the same thing, are they? And what is your BMI?

Share this post


Link to post
Share on other sites

Blue Cross Blue Shield of Michigan and Blue Care Network aren't the same thing, are they? And what is your BMI?

I worked there up or 7 years ago

BCN is the subsidiary and it's the hno product. Their medical policies are different than bcbsm which is ppo, EPO, indemnities

I would call bcbsm directly and ask them. Even if you are not a customer today they c an give you the medical policy

Share this post


Link to post
Share on other sites

Yes! My mom had BCBSM and the six months was waived because her BMI was over 50. Mine was under 50, so I had to do the six months.

The strange thing about the approval process with BCBSM is they do not do preapprovals. The Drs office submits the claim after your surgery is complete. They approve the surgery and only ask for the dietician appointment, psych eval, weights, etc if needed.

Share this post


Link to post
Share on other sites

@@juhneefurr was the six months waved for you?

As far as I can tell. I'm still pre-op, but everything is pointing to it being waived. That's what everyone I have talked to has said, and even the insurance before I purchased it for the year, I asked them directly and they said it would most likely be waived. So now I'm waiting to have my sleep study and be submitted to the surgeon and the insurance for approval and we'll see.

If it does indeed end up getting waived, then I will post it back on here!

Share this post


Link to post
Share on other sites

Yes. She's exactly right. My BMI is 50.3 and no 6 months of dieting required. And blue Cross Blue Shield of Michigan doesn't do preapprovals. They simply pay.

Share this post


Link to post
Share on other sites

I have BCBS of MI as well. My BMI is 51.9, and I am just beginning to start the process. My first appointment is later this month, however I am surprised to learn that in some cases the waiting period is waived. I will post again here when I learn more.

Thank you for sharing!

Edited by MsAlaineus

Share this post


Link to post
Share on other sites

50 bmi. There is no waiting period for BCbS of Michigan.

Share this post


Link to post
Share on other sites

You're right, Monopoly!

The cut off is 50. Anything above eliminates the six month wait.

Anyone know how long the process is without the 6 months?

Share this post


Link to post
Share on other sites

How was the process for you, I have had my first round of appointments and My BMI is over 50 which is waiving the 6 month of diet. How fast did the process go for you?

Share this post


Link to post
Share on other sites

Faster than I was ready for! I'm being told my surgery will be early May!

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

    • 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.
    • Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 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

    ×