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BCBS requirements

mommabear2311

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mommabear2311    31

mommabear2311
Posted

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~

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smills7382    10

smills7382
Posted

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.

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Rae5148    28

Rae5148
Posted

Bcbs 6 months in Connecticut

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Monet08    63

Monet08
Posted

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

OutsideMatchInside
Posted

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.

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seeingme    91

seeingme
Posted

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.

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anrobe    34

anrobe
Posted

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

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kmorri    1,689

kmorri
Posted

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.

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kitkattulsa    28

kitkattulsa
Posted

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

Nana1222
Posted

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

txvsg
Posted (edited)

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 by txvsg

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