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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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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
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    • KimBaxleyWilson

      KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
      · 0 replies
      1. This update has no replies.
    • bellaamey

      bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
      · 0 replies
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