I have BCBS Fed and have a question about their requirements...I had the lapband placed in Feb 2011. Long story short, I had it removed due to infection in November 2013 (2 years ago). When I had it removed, I had already gained a few pounds putting my BMI around 31. I have consistently gained weight over the past 2 years making my current BMI 40.1. Does anyone know how this will effect my approval for the sleeve? Since I don't have a 2 year weight history of having an "obese BMI". My patient advocate at my surgeons office is optimistic of my chances. I'm just having a hard time wrapping my head around the possibility of going through my 3 month supervised diet and testing to be denied 3 month from now. It's stressing me out.

Approved at the peer to peer!!! Surgery on Tuesday! OMG! Can not believe this is happening. Now I am kind of panicking!

Congratulations you will be fine. So happy for you. ????

Congratulations! I'm so happy for you!!!! Woohoooo

Thanks for the support. Will post when it's over!

@@MeFirst

So I had my first surgeon appt. Everything went awesome! According to my insurance advocate everything is great! I even asked her if she thought I should switch insurances and she said there was no need... We are just going to exclude the 204 weigh in.... I even got to have my NUT appt today! So I should be doing my last appt and ready to submit Feb 10! Even my doctor promised if my insurance covers surgery, they WILL get it approved! fingers crossed! I will keep you updated!

If your having surgery in 2016 you just need one weight from 2014 and one from 2015 that's shows your BMI over 35. Even if you had a BMI under 35 for most of the year if they can find one in the entire year that shows over 35 you're good.

@@Nora82

Thanks! That's exactly what my surgeons office said!

@"Jane13"

I'm in Jax too . I'm getting my sleeve at St. Vincents with Dr Uchal pending insurance approval.

Who was your Surgeon and what hospital did you use?

I'm using dr. Uchal as well schedule surgery was December 9th but having issues with approval so I'm hoping the 16th!

I have the same insurance. I have weight history for 2013,2015 and got denied because I didn't see a dr in 2014. Don't know what to do now. ????

If your having surgery in 2016 you just need one weight from 2014 and one from 2015 that's shows your BMI over 35. Even if you had a BMI under 35 for most of the year if they can find one in the entire year that shows over 35 you're good.

I was just rereading through this thread. Do you think that an "obese" weigh in on 2014, 2015, and 2016 would satisfy the 2yr weight history requirement? Even if the time between weigh ins was not 24 months apart. I have a weight record for sept 2014, sept 2015, and will have one in January 2016.

**feeling hopeful

Yes absolutely. They just look for the year, month doesn't matter. You just need one recorded weight from each year.

Thank you so much for the info! ????

I also have BCBS Fed and they approved my band to sleeve revision. It was all done at once. I danced around the weight requirement as I don't think I technically met it. I had band complications after 14 years banded and regained a lot of weight during the last two years prior to my revision due to having a complete unfill, which did not resolve my issues.

I wrote a letter explaining my history and stated I had been successful with the band until my complications (gastritis, esophagitis, hiatal hernia, left shoulder pain). I wrote how the restriction from the band had helped me lose the weight and maintain it, and how I had regained without restriction. I also wrote about how my quality of life had changed when I had lost the weight etc.

If you log on to your fepblue account they will have on there a list of everything you have ever been assessed and diagnosed with. I used all those things on my letter. I was approved very quickly. It might not hurt to just put together your letter with your history and any supporting records (I attached imaging studies from my upper GI showing the gastritis etc, PCP records with a weight history, and records from a band surgeon I was seeing a couple of years prior in which he noted my complications).

Let me know if you have any questions. Tag me so I get a notification.

"VDLT" thank you so much for your detailed response!! Awesome!

I wish I would have gone straight from band to sleeve. Silly me, I thought I could maintain my weight on my own.