My APPROVAL story with BCBS Federal (TX)

[NewLife1985 45]

As of yesterday I'm officially APPROVED with BCBS Federal!!! I am soooooo happy! I feel so blessed for this opportunity! Currently waiting for my surgeon's office to schedule a date!!! I just wanted to post all the requirements and stats for anyone going through the insurance process with BCBS Federal. I had a ton of questions and this website was a god send, so here it is... GOOD LUCK!

Age: 30

Gender: Female

Height: 5.6

Weight: 236

Insurance: Blue Cross Blue Shield-Federal (Basic)

Surgeon: Dr. Lloyd Stegemann (The Better Weigh Center)

Location: Corpus Christi, Texas

Requirements:

2 year history of being overweight

February 2014-204lbs (excluded fell below 35 BMI) * All they need is ONE record for that year*

October 2014-214lbs

January 2015-215lbs

September 2015-220lbs

February 2016-236lbs (Current)

Co-morbidity

High Blood Pressure (Lisinopril with HCTZ)

Pre-Diabetic (Metformin)

Nutritional Counseling (3 months prior to surgery) *Must be 90 days*

11/18/2015; 12/16/2015; 01/13/2016; 02/18/2016

Evidence of Failed Weight Loss

Just a list of diets I’ve tried/failed

Psychological Clearance

1hr meeting with Bariatric Counselor

No Smoking for 6 months

Easy I don’t smoke

No treatment of substance abuse 1 year prior to surgery

Easy I don’t do drugs! (LOL)

11/04/2015-PCP ($25.00) Diagnosed with High Blood Pressure (I already knew I had it, just needed to get diagnosed)

11/18/2015-The Better Weigh Center ($35.00) 1st consult with Surgeon

11/18/2015-NUT ($50.00) 1st meeting/1st weigh in (227lbs)

12/04/2015-sleep Rite ($100.00)-Sleep Apnea Testing

12/16/2015-NUT ($20.00) 2^nd Meeting/2^nd weigh in (227lbs)

12/30/2015-Psych Evaluation ($25.00)-Passed

01/13/2016-Pre-registered at hospital for Endoscopy and had Blood Work, Chest X-Ray, EKG at hospital

01/13/2016-NUT ($20.00) weigh in (230lbs) GAINED

01/18/2016-Endoscopy ($100.00 COPAY plus 30% of Drugs, Agents, and Supplies)

*Received an additional bill for $156 from Surgeon*

*Received an additional bill for $60 from hospital*

01/26/2016-Biopsy revealed H. Pylori (Must take anti-biotic)

*Will NOT affect surgery date*

02/18/2016-NUT ($20.00) Last weigh in (236) GAINED

*Package COMPLETED*

*Insurance received and uploaded forms 02/18/2016

APPROVED!!! 2/25/2016

*UPDATE*

02/29/2016-Surgery scheduled for March 15th!

02/29/2016-Registered at Hospital ($350.00) 2 days minimum at hospital

03/01/2016-Started Pre-Op liquid diet

03/08/2016-NUT ($20.00) Post Op instructions

03/08/2016-The Better Weigh Center ($40.00) Last appointment with Surgeon

*Surgery Copay for Surgeon ($200.00)*

Edited March 6, 2016 by NewLife1985

[Careysgirl 20]

Wow what a detailed summary, I have BCBS NJ they approved me in 24 hours I did pretty much everything you had listed in your summary except my insurance did not require 2 year history of weight loss but did require 6 months of supervised weight loss I was doing WW so that counted and did another 3 months with nutritionist. My surgery date is March 7th what is yours?

[Hulabird 10]

Thank you for that excellent summary! I have BCBS-Federal, so that was helpful. I am just starting on my weight loss journey, my first appointment with the surgeon is on March 7, 2016. So I have many hoops to jump thru, but i'm ready!

May I ask, what is the purpose of the endoscopy? does everyone have to get that?

[NewLife1985 45]

Wow what a detailed summary, I have BCBS NJ they approved me in 24 hours I did pretty much everything you had listed in your summary except my insurance did not require 2 year history of weight loss but did require 6 months of supervised weight loss I was doing WW so that counted and did another 3 months with nutritionist. My surgery date is March 7th what is yours?

I find out on Monday! I will let you know!

Wow what a detailed summary, I have BCBS NJ they approved me in 24 hours I did pretty much everything you had listed in your summary except my insurance did not require 2 year history of weight loss but did require 6 months of supervised weight loss I was doing WW so that counted and did another 3 months with nutritionist. My surgery date is March 7th what is yours?

I find out on Monday! I will let you know!

[NewLife1985 45]

Thank you for that excellent summary! I have BCBS-Federal, so that was helpful. I am just starting on my weight loss journey, my first appointment with the surgeon is on March 7, 2016. So I have many hoops to jump thru, but i'm ready!

May I ask, what is the purpose of the endoscopy? does everyone have to get that?

You're Welcome! Not everyone doesn't get one. It depends on your surgeon. I did mine as an outpatient procedure in the hospital. Some surgeon 's do them in their office. When they did mine they discovered H. pylori... I read some people discovering hernias, ulcers, and life threatening bacteria! So needless to say I think it's a precaution. Good Luck on your Journey, it will go faster than you think!

[wileyns 16]

I have bcbs federal too and got approved 2/25/16 surgery date is 4/12/16 :-)

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[NewLife1985 45]

Wow what a detailed summary, I have BCBS NJ they approved me in 24 hours I did pretty much everything you had listed in your summary except my insurance did not require 2 year history of weight loss but did require 6 months of supervised weight loss I was doing WW so that counted and did another 3 months with nutritionist. My surgery date is March 7th what is yours?

Just got my date today! March 15th!!! Starting my pre-op tomorrow!

[lyncray 1]

Hi there,

I am so excited for you ,I too am with BCBSTX and live in Longview, are you going to Mexico for your procedure, and did BCBSTX approve it, I am just starting this process with Bariatric Pal and would love to have as much info as possible.

Lyncray

[futurern 1]

Your summary was very thorough! Thanks for posting.

[Christinamo7 4,041]

I also had surgery with BCBS Federal, standard. I had to do 3 months of PCP supervised diet. Thankfully the weight loss center I went to had NUT and psych in the same umbrella, so each time I go and see who I need to see it is only one copay.

all together it will end up costing me about 1000, copays were at the time of visit, and 350 surgery prepay. Not bad to change my life forever, I reckon I will save that in food this year alone.

[JoJo13 1]

@@NewLife1985, Do you have BCBS Federal..Standard? or Basic?

[NewLife1985 45]

Yes BCBs Federal Basic

[JoJo13 1]

Yes BCBs Federal Basic

Ok. Cool. Thank you. Just trying to get an idea of what to expect. I have the same.

[totalblamblam75 0]

Yes BCBs Federal Basic

How did it go?? I am scheduled with Dr. Stegemann on the 14th of June!

[Deletemyacct 39]

That's awesome! Thank you for sharing, i have bcbs-ca & been trying to find the level of detail you provided for my insurance plan. Thank you & i hope all is well!

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