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Experiences with BCBS - Illinois

Hi everyone! I'm just starting to look into WLS, and I'm curious about people's experiences with BCBS-Illinois. What hoops did they have you jump through? How long did it take to get approved?

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Super easy, they approved me quickly (under a week) .

It was my surgeon who recommended 3 months of meeting w/a nutrionist before scheduling the surgery.

I have BCBSIL too. They have 3 requirements: (1) BMI - 40+, or 35-39 with recognized co-morbidities, (2) nutritional consult, and (3) psych evaluation. No supervised diet requirement. Approval is within 30 days of submission (many average about 7 days).

For me, my surgeon's office submitted me to BCBSIL on 12/10 and they denied me 12/17. Surgeon resubmitted me 12/28 and 1/5 BCBSIL approved me. My surgery is set for 2/26.

  • Author

I have BCBSIL too. They have 3 requirements: (1) BMI - 40+, or 35-39 with recognized co-morbidities, (2) nutritional consult, and (3) psych evaluation. No supervised diet requirement. Approval is within 30 days of submission (many average about 7 days).

For me, my surgeon's office submitted me to BCBSIL on 12/10 and they denied me 12/17. Surgeon resubmitted me 12/28 and 1/5 BCBSIL approved me. My surgery is set for 2/26.

Woo-hoo! Congratulations!

  • Author

I went to my first consultation yesterday, and the insurance counselor assured me that BCBS-IL is a good insurer. No diet required. They are requiring medical records for proof of co-morbidities (I'm under 40 BMI). No other requirements for me other than nutritionist and psych eval, which the surgeon also requires. The insurance counselor did say BCBS-IL is slow, which is odd because I've heard the opposite on this forum.

I have BCBSIL. I started on my WLS journey in august 2015. My bmi was 56 or 57, insurance required psych eval and 30 day follow up with surgeon. Because I was a bad snorer, surgeon required sleep study which confirmed sleep apnea. Got my cpap and everything was filed the end of October. End of November I got the call of approval and 12/14/15 I was sleeved. So for my experience it was only a 4 month process. Good luck to you!

  • 2 weeks later...

I went for my first doctors appt on 12/10. Did psych eval, nutrition visit, lab work... Submitting tomorrow. BMI is 37 and I have osteoarthritis. My labs showed high cholesterol, ldl and prediabetic. We shall see. I'm hoping this happens. I'm very nervous. Hoping for late March/early April surgery date.

  • Author

I have BCBSIL too. They have 3 requirements: (1) BMI - 40+, or 35-39 with recognized co-morbidities, (2) nutritional consult, and (3) psych evaluation. No supervised diet requirement. Approval is within 30 days of submission (many average about 7 days).

For me, my surgeon's office submitted me to BCBSIL on 12/10 and they denied me 12/17. Surgeon resubmitted me 12/28 and 1/5 BCBSIL approved me. My surgery is set for 2/26.

Approval within 30 days? Ugh. I hope mine is closer to the 7 you mentioned.

When I was approved, I called them about something else, and I asked if I was approved, and they told me, that was at a week or less than a week, and within a few days the letter came in the mail. The Dr office took another 2 weeks or so to call me and me I was approved.

  • Author

When I was approved, I called them about something else, and I asked if I was approved, and they told me, that was at a week or less than a week, and within a few days the letter came in the mail. The Dr office took another 2 weeks or so to call me and me I was approved.

Hmmm, I'll have to try that. I didn't think about calling them myself. Thanks!

It's going fast for me.. I went for my consultation on 1/20/16. With my insurance, and possible yours (I'm PPO) they don't require a medical assisted diet. So I was told around the end of February to beginning of March is when I will have surgery (if everything comes back good for all my testing). And my mouth dropped. They scheduled all of my test that day except my EGD test.. which will be scheduled as soon as my EKG test clears. First they sent me downstairs after my consultation for labs. I had to blow into a bag.. drink something that tasted like lemonade.. then wait 5 mins and blow into another little bag, and they took blood work. My Radiology/Ultrasound tests, and Psychology appointments were on 2/3/16. My EKG/Stress tests, and Nutrition class are tomorrow morning 2/8/16. My At Home Sleep Study test is on 2/11/16. She said they will be submitting my paperwork next week to insurance.. and I'm like WOW.. I knew I wouldn't have to jump through so many hoops but this is so fast I'm getting nervous. And I made a post asking a similar question and many told me how fast the process went for them, and it's no joke.. with my experience. My Radiology test came back good, and I was cleared by my Psychologist. So warning.. don't be surprised if this process goes fast. Good Luck to you!

Edited by LadyWarren

I agree. It does go fast. First appt for me was 12/10, sleep study 12/17. Psych eval 12/22. Saw the psych again 1/11 and nutritionist 1/17. Lab work was done 1/13. 1/22 was abdominal sonogram (checking my gallbladder) Met surgeon again 2/4 and endoscopy 2/7. Only reason my surgery would be schedule last week of March/beginning of April is because I'm traveling out of country end of Feb for 2 weeks. After I come back- hoping they approve my surgery- I do the 2 week pre op diet and then I get sleeved.

I can't wait!!

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