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BCBS requirements and approval time

Just wanting to prepare myself and waiting for my doc appointment next week is taking forever! Has anyone else felt like something will go wrong and you won't be able to get the surgery? Maybe because I have failed so many diets, I just feel like this won't work out either.

I have BCBS of Texas and have a BMI right at 40. No co morbidities. I now have my husband and family on board and I really really want this for myself. Everything I have read says its relatively simple process through BCBS but gosh I just want to be prepared!! I have obtained all medical records from my pcp back 3 years because before that I didn't see a dr, and even after I have maybe two visits a year.

Anyone else have similar insurance and what was your approval experience?

Waiting sucks!!

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All my appointments have been great, i just have one last appointment tomorrow to speak about exercise. The only thing that worries me is not getting clearance by my primary care provider. I have BCBSNC and had my EGD today, everything is going smoothly.

  • Author

Was it a requirement of your insurance to have the EGD or the physician? I have had two over the phone interviews and attended the seminar both in person and online. Insurance covers the procedure and my first appointment with the surgeon is next week on the 20th. I am just so nervous and it's taking forever! I have this feeling like it is never going to happen. I am sure it is just nerves. :)

It is a requirement for the surgeon. Not the insurance company.

  • Author

Gotcha. From what I was told, I will need one nutritionist visit and one psych evaluation. BMI over 40 and then I get the approval. Let's hope this goes as smoothly as I've been told.

I have BCBS of Michigan but I live in Texas, and they told me that BCBS doesn't do pre-approvals, you just have to follow the guidelines they give and if you do they will cover you. I had my initial visit July 15th and got my requirements letter within two weeks. Since my BMI is over 50 the six month doctor supervised diet was waived now all I have to do is a Psych Eval on Tuesday and they will set a date! I felt the same way you did when I started but the ball will start rolling pretty quick I promise, good luck!

I have BCBS of Michigan but I live in Texas, and they told me that BCBS doesn't do pre-approvals, you just have to follow the guidelines they give and if you do they will cover you. I had my initial visit July 15th and got my requirements letter within two weeks. Since my BMI is over 50 the six month doctor supervised diet was waived now all I have to do is a Psych Eval on Tuesday and they will set a date! I felt the same way you did when I started but the ball will start rolling pretty quick I promise, good luck!

  • Author

Thanks:) I hope it goes quickly enough. I am just ready to get myself back!! Being overweight has really changed me into someone I can't stand. I had never been one to stay to herself and the more weight I gain the more I find myself withdrawing. It especially sucks that my kids have to suffer because mommy doesn't feel comfortable at the water park or beach.

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