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

BCBS requirements and approval time



Recommended Posts

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!!

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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. :)

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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!

Share this post


Link to post
Share on other sites

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!

Share this post


Link to post
Share on other sites

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.

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

    • ChunkCat

      I have no clue where to upload this, so I'll put it here. This is pre-op vs the morning of my 6 month appointment! In office I weight 232, that's 88 lbs down since my highest weight, 75 lbs since my surgery weight! I can't believe this jacket fit... I am smaller now than the last time I was this size which the surgeon found really amusing. He's happy with where I am in my weight loss and estimates I'll be around 200 lbs by my 1 year anniversary! My lowest weight as an adult is 195, so that's pretty damn exciting to think I'll be near that at a year. Everything from there will be unknown territory!!

      · 2 replies
      1. AmberFL

        You look amazing!!! 😻 you have been killing it!

      2. NickelChip

        Congratulations! You're making excellent progress and looking amazing!

    • BeanitoDiego

      I changed my profile image to a molecule of protein. Why? Because I am certain that it saved my life.
      · 0 replies
      1. This update has no replies.
    • eclarke

      Two years out. Lost 120 , regained 5 lbs. Recently has a bout of Norovirus, lost 7 pounds in two days. Now my stomach feels like it did right after my surgery. Sore, sensitive to even water.  Anyone out there have a similar experience?
      · 0 replies
      1. This update has no replies.
    • 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.
  • 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

    ×