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

Experiences with BCBS - Illinois



Recommended Posts

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?

Share this post


Link to post
Share on other sites

No hoops but my BMI was high. Approved after being submitted in 7 or 10 days.

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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!

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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!

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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!

Share this post


Link to post
Share on other sites

Awesome. At 6 months I feel like normal, just smaller appetite.

Share this post


Link to post
Share on other sites

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

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

    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
    • Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 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

    ×