BCBS requirements

[mommabear2311 31]

Well here's an update.... I called my insurance because I found several things on line about coverage and it was all different then what I have been told at the weight loss center even. I have BCBS of Michigan. The representative said that the monitoring period is 6 months unless your BMI is more than 50 then the 6 months of monitoring is waived. Mine is 55.4. This is the one time that being super morbidly obese has been good for me! I really need to start this weight loss journey. I am having a lot of health issues and am looking forward to every minute of becoming healthier!

~Sandy~

[KristenLe 5,979]

@@mommabear2311 That's what happened with me too - except it took 2 months to find that out. Hope everything goes smoothly!

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[smills7382 10]

Well here's an update.... I called my insurance because I found several things on line about coverage and it was all different then what I have been told at the weight loss center even. I have BCBS of Michigan. The representative said that the monitoring period is 6 months unless your BMI is more than 50 then the 6 months of monitoring is waived. Mine is 55.4. This is the one time that being super morbidly obese has been good for me! I really need to start this weight loss journey. I am having a lot of health issues and am looking forward to every minute of becoming healthier!

~Sandy~

I'm in Michigan too and also have bcbsm. I'm having my surgery at sparrow.

when I went to my first appt yesterday she said that if I get all my tests,and appts done I could have my surgery in 2 months. my bmi is over 50 as well.

[Rae5148 28]

Bcbs 6 months in Connecticut

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[broncos.babe 2]

I live in Ks and it is 6 months. U cannot miss one appt or u start all over at day 1

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[ltrepaney 1]

6 months in NH of supervised diet for BCBS ANTHEM.

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[Monet08 63]

Also with bcbs you have to stay on top of them bc I did the 41/2 months of the requirements and my office felt I did enough to submit. Well come to find out if it's outpatient which it is no requirements or arborizations needed. Only inpatient. I will only be there for 23 hour observation unless something goes wrong and then in that case they just submit for inpatient auth.

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[OutsideMatchInside 10,166]

It varies by state, plan and BMI. BCBS is not one company, there are several BCBS in the country and they are all have different rules and operate differently.

[seeingme 91]

I'm in Minnesota, and the 6 months is required by BCBS. I just had my 5th visit with the dietician and finished my psychology assessment. My last dietician visit will be spent going over pre-op liquid diet and post-op care. I had to laugh a bit at my psychology assessment. Their main yellow flag for me was "You may not take the time to take care of yourself because you're taking care of everyone else." Well yes, I have 6 kids with disabilities in my house. My role is caretaker!!! LOL I am really trying to do a better job of taking care of me though.

[bia1nca1 38]

Got my surgery date 9/28, BCBS approved me in 8 business days

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[anrobe 34]

I have BCBS of NC and I have no supervised diet. They have very few requirements.

[kmorri 1,689]

I retired from BCBS of Floridia back in September and it not only varies by state it varies by the individual plans....your best bet is to call customer service number on your card and ask them about the coverage criteria for bariatric surgery. Also ask them to mail you a copy.

[kitkattulsa 28]

BCBS-Anthem requires 6 months. I had to maintain due to my bmi...fingers crossed I am done in 2.5 weeks then it goes for approval

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[Nana1222 159]

I tried calling them three times and they won't release any info on that topic with me. They tell me to call the surgeons office. They also won't say anything until my appt. So I gave up and will just wait. But I did start mtg with my PCP monthly anyways can't hurt anything.

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[txvsg 154]

Yeah I live in Texas but have bcbs of IL and was able to be sleeved within about two months of looking into it. I didn't have to be monitored on a diet just a few small steps. Also depends on your job they sign up for specific groups of coverage with different requirements.

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Edited September 1, 2016 by txvsg