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

Pending approval



Recommended Posts

Hi all,

I currently have a BMI of 41 and I'm 5'4" and no comorbidities. I have BCBS of IL and all my paper work was submitted yesterday. Now it's a matter of waiting but now I'm freaking out, what if they don't approve. Does anyone else have this insurance and has anyone had any issues with the approval?

Share this post


Link to post
Share on other sites

Good luck! I think everyone goes through the emotions you are, it was stressful when my paperwork went over as well. You will be fine!

Share this post


Link to post
Share on other sites

I had BCBS IL and was approved! my BMI was 42 and I also had no co-morbidities. I wasn't one of the lucky ones who got their approval in 24-48 hours and had to wait like 2 weeks though.

Share this post


Link to post
Share on other sites

Haha thanks! I was just freaking out because it just happens to be that I received a call from them yesterday evening telling me that the place I work for has this wellness plan that can help me lose weight.

Share this post


Link to post
Share on other sites

I'm just starting the process with bcbsil. What requirements did you have to meet? I can't use a local hospital. I have to go two hours away to a blue certified hospital.

Share this post


Link to post
Share on other sites

I'm just starting the process with bcbsil. What requirements did you have to meet? I can't use a local hospital. I have to go two hours away to a blue certified hospital.

I had to do 6 month supervised weight loss diet with a physician, 1 visit with the nutritionist, 1 psychological evaluation, a letter from the physician saying that the operation is medically necessary and they also needed 2 years worth of medical records.

Share this post


Link to post
Share on other sites

Looks like I have a long road ahead of me. I had band surgery in 2011 through insurance with the same requirements you had. Then the band slipped and port flipped in 2012. Insurance had changed so had to pay out of pocket to have it taken out. My insurance just started covering bariatric this year.

Share this post


Link to post
Share on other sites

Oh wow! I thought about the LapBand at first since I really don't know anyone who's done the surgery and it just seemed like the less invasive, but the more I looked into it the more revisions I saw. It's a long process but time goes by fast :-) especially if you have a good support system!!

Share this post


Link to post
Share on other sites

I'm just starting the process with bcbsil. What requirements did you have to meet? I can't use a local hospital. I have to go two hours away to a blue certified hospital.

I just had to have a psych eval, one nutrition class, I also had to go to a blue distinction center but luckily I live like 10 mins away from one.

Share this post


Link to post
Share on other sites

I had lap band in February 2011. My work insurance didn't cover it. But I wasn25 and learned my moms covered it. So she added me thankfully. Then during surgery my surgeon aimed a little high and hit my lung cavity. So I had a collapsed lung and had to stay over night. Then because the port was hitting my rib that had to be moved. Thankfully that was under insurance as I lost my parents insurance when I turned 26 in sept. In December things started going down hill with an emergency unfill. I was ver fortunate because my doctors wife was available. Then again in the spring it happened. My dr and his wife were out of town on a weekend but they were coming home that night and I met them at the hospital for an unfil. Fast forward. After a July vacation I came back in for a fill. He couldn't get the port to accept a fill. Kept hearing a metallic sound and bent the needle. He fiddled around and poked me (I gave him permission to keep trying) for at least an hour. Next week I had a swallow test and reg X-rays and the band had slipped and the port flipped. I was the first port flip he had ever had. I had to pay over 7k out of pocket to have it removed. I could have kept it but didn't want to pay to fix then pay to remove if something else happened.

I had lost 100lbs since I signed up for the first seminar. So I think that was 70 lbs with band counting the week after surgery. I was miserable and didn't realize how bad it was. Contortion tricks were used to try to get unstuck or throw up. Hanging over the end of the sofa to remove whatever plugged the whole to my stomach. It was horrible and I didn't see how bad till I had relief.

I also gained back all but 30-40 lbs. I had pneumonia that required daily outpatient treatment. All my doctors said that all the antibiotics caused such a weight gain. Been to thyroid specialist as I have all the symptoms only to be compared to a cow receiving antibiotics to gain weight. Needless To say 2012 sucked.

I just noticed in January that my insurance no longer had the big red exclusion for bariatric surgery and emailed. My company is literally 500 feet from my old hospital but since they aren't blue certified I will be going two hours away.

I wish you luck in getting your surgery. Thankfully the sleeve seems to not have the long term complications that the band has. I have submitted my paperwork to the hospital to get the first appointment. My email from bcbsil didn't list the 6 month diet so crossing my fingers.

Share this post


Link to post
Share on other sites

I had lap band in February 2011. My work insurance didn't cover it. But I wasn25 and learned my moms covered it. So she added me thankfully. Then during surgery my surgeon aimed a little high and hit my lung cavity. So I had a collapsed lung and had to stay over night. Then because the port was hitting my rib that had to be moved. Thankfully that was under insurance as I lost my parents insurance when I turned 26 in sept. In December things started going down hill with an emergency unfill. I was ver fortunate because my doctors wife was available. Then again in the spring it happened. My dr and his wife were out of town on a weekend but they were coming home that night and I met them at the hospital for an unfil. Fast forward. After a July vacation I came back in for a fill. He couldn't get the port to accept a fill. Kept hearing a metallic sound and bent the needle. He fiddled around and poked me (I gave him permission to keep trying) for at least an hour. Next week I had a swallow test and reg X-rays and the band had slipped and the port flipped. I was the first port flip he had ever had. I had to pay over 7k out of pocket to have it removed. I could have kept it but didn't want to pay to fix then pay to remove if something else happened.

I had lost 100lbs since I signed up for the first seminar. So I think that was 70 lbs with band counting the week after surgery. I was miserable and didn't realize how bad it was. Contortion tricks were used to try to get unstuck or throw up. Hanging over the end of the sofa to remove whatever plugged the whole to my stomach. It was horrible and I didn't see how bad till I had relief.

I also gained back all but 30-40 lbs. I had pneumonia that required daily outpatient treatment. All my doctors said that all the antibiotics caused such a weight gain. Been to thyroid specialist as I have all the symptoms only to be compared to a cow receiving antibiotics to gain weight. Needless To say 2012 sucked.

I just noticed in January that my insurance no longer had the big red exclusion for bariatric surgery and emailed. My company is literally 500 feet from my old hospital but since they aren't blue certified I will be going two hours away.

I wish you luck in getting your surgery. Thankfully the sleeve seems to not have the long term complications that the band has. I have submitted my paperwork to the hospital to get the first appointment. My email from bcbsil didn't list the 6 month diet so crossing my fingers.

Thanks!!

Ahh omg, I'm sorry you've been through so much!! Hopefully this time around things will go a little bit smoother for you! :-)

Share this post


Link to post
Share on other sites

@mis4may I too have a BMI of 41 & no co's and my approval took a little over a week... Congrats on your date!! You are a day before me..

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

    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 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. 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.
  • 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

    ×