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BCBS requirements and approval time

Astrosgirl

By Astrosgirl, in Insurance & Financing

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Astrosgirl    96

Astrosgirl
Posted

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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queencity    62

queencity
Posted

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.

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Astrosgirl    96

Astrosgirl
Posted

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. :)

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Astrosgirl    96

Astrosgirl
Posted

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.

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Lacfish13    14

Lacfish13
Posted

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!

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Lacfish13    14

Lacfish13
Posted

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!

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Astrosgirl    96

Astrosgirl
Posted

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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Go To Topic Listing Insurance & Financing

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    • Alisa_S

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      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.
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      1. summerseeker

        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.

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