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BC/BS Co Morbities?

:( Hi Everyone!

Has anyone with BCBS and a BMI of 35-40 had the surgery approved if you have a comorbitys like asthma and Gerd not necessarly the ones that are listed on their list....I was wonder because they say "such as" in the writing making me think that those are examples of ones they cover not ALL of them....Thanks for Any Info!!! ~Xgrl

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I have BCBS of CA Federal. My BMI is 37 and my co-morbidities are hyperlipidemia, GERD, PCOS, Metabolic syndrome, infertility, ammenorrhea, stress incontinence. My Dr should submit to insurance in the next couple weeks. Im REALLY hoping to be approved. I dont feel like I have any of the big "red herring" comorbidities they mention either...I guess we will see...Good luck to us both!

  • 2 weeks later...
  • Author
I have BCBS of CA Federal. My BMI is 37 and my co-morbidities are hyperlipidemia, GERD, PCOS, Metabolic syndrome, infertility, ammenorrhea, stress incontinence. My Dr should submit to insurance in the next couple weeks. Im REALLY hoping to be approved. I dont feel like I have any of the big "red herring" comorbidities they mention either...I guess we will see...Good luck to us both!

Hey I was wondering if you've heard anything yet? I know it wasn't all that long ago just curious? did your dr say that he thought it would go one way or the other with the insurance? Good Luck ~Xgrl

I have BC&BS of IL. they required I have a psy. eval, thyroid test, BMI of 40, 100 lbs. over weight and a referral from my Dr. However, I have GERD and double knee replacements. They approved me in 4 weeks. Good luck.

JP

  • 5 weeks later...

Sorry it took so long to respond, I didnt have any news until now. I just received my letter today. I was approved!! I ended up getting approved from BCBS of NV though not CA where I live. I will be having surgery in Reno, so it had to be sent to the NV BCBS. Im so excited! Whats going on w/ yours now?

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Hey Nothing much new here had my first consult it sounded promising, I'm super excited you got approved i was really worried about it since we're in similar situations right now i'm just waiting to hear from the clinic i had to have all my medical records from my Doc sent to the surgeon so it's not kind of a waiting game.....waiting....waiting... already tired of waiting can't wait till i find something out. Have you set a date for the surgery yet? I was hoping to get mine in during Winter Break so i could go back to school and not be hurtin. Good Luck With everything ~Xgrl

I have BC/BS of GA Federal PPO. I had a BMI of 35. I had to get a letter of neccessity from my doctor stating my comorbidities and that she felt Lapband Bariatric surgery was by best option. I also had to write a letter detailing my various attempts at weight loss along with starting/ending weights. I have asthma, arthritus, sleep apnea, and lymphadema. After sending all information in, I got approval to do the surgery(took 2 weeks). There is hope.:)

Congradulations!!! My date is Aug. 15 I just starte the pre-op diet today. Not to bad so far. Two carnation shakes a day and one low fat low sugar meal. Good luck to you.

JP

  • 2 weeks later...

:help: Hi - I have BCBS of Nebraska through my husband's group policy at work. My BMI is 35 but I have sleep apnea, hypertension, arthritis, plantar fasciitis & high cholesterol. I am scheduled for my first evaluation. Sept 6th with Dr Taddeucci in Lincoln.

First call to BCBS they said there were benefits for the surgery if I had the right codes. Second call I gave them the code for LapBand surgery and they said I was not covered. Third time (it wasn't the charm) they said there were no benefits in our policy for any kind of baratric surgery.

Has anyone else had this problem with BCBS of Nebraska?;)

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