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Hey everyone! My name is Katie and I'm just beginning this Gastric Sleeve adventure. I went to a required seminar and was given some questions to ask my insurance company. They were: what is the required bmi, how many nutrition visits are required and how many physicians visits. So the insurance company said that these limits didn't exist I just needed a pre authorization for surgery. I contacted the surgeons office to see if this sounded right and they said that the surgeon will tell me the required length or time and bmi. Does anyone have an idea if this sounds right? All the reading I've done I expected to hear 35 to 40 bmi, and 90 days or six months of nutrition and physician appointments. Does this mean my insurance might not have these limits or the surgeons office will tell me the requirements??

Edited by HealthierMe2017

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  • HealthierMe2017
    HealthierMe2017

    Okay! I definitely will! Thank you for your help [emoji4]

  • HealthierMe2017
    HealthierMe2017

    Unfortunately, I was wrong [emoji20]. I am borderline BMI requirements and have to have an additional comorbidity to qualify. I'm currently waiting for my sleep study results which will make or break

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You can look up your requirements on your insurance website...with mine...I need 35 bmi with at least 1 comorbities and or 40 bmi healthy. Reaches my final growth 18 years of age and a psychologist stating in understood my post diet. Then there were my surgeons requirements as well

Sent from my SM-G920V using the BariatricPal App

  • Author

Yep... My insurance said the same thing. My bariatric team that they have a set number of visits and bmi. So this is not all off the wall stuff. What insurance do you have?

Sent from my LGLS755 using the BariatricPal App

I have Carefirst bluechoice. I guess I just figured it would be a set number of visits before they paid for it. Do you know what the Bariatric team bases that on?

Ok i looked up your insurance and you do have requirements

Sent from my SM-G920V using the BariatricPal App

http://www.obesitycoverage.com/bcbs this is the requirements on your insurance...I'm not sure how up to date they are but this is what found

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  • Author

Thank you! That is what I found and couldn't figure out what the insurance rep said she couldn't find any of these requirements. Maybe it's something they give the provider and not directly to the patient. Thank you for your help!!

Thank you! That is what I found and couldn't figure out what the insurance rep said she couldn't find any of these requirements. Maybe it's something they give the provider and not directly to the patient. Thank you for your help!!

No problem, I'm an insurance agent myself and most insurance fall Center reps are not licensed. I would call again and see if you get a different answer and take fornication the names of who you speak with

Sent from my SM-G920V using the BariatricPal App

  • 3 weeks later...

Thank you! That is what I found and couldn't figure out what the insurance rep said she couldn't find any of these requirements. Maybe it's something they give the provider and not directly to the patient. Thank you for your help!!

No problem, I'm an insurance agent myself and most insurance fall Center reps are not licensed. I would call again and see if you get a different answer and take fornication the names of who you speak with

Sent from my SM-G920V using the BariatricPal App

"Take fornication...."

ROFL

Sent from my SM-N920R4 using the BariatricPal App

Thank you! That is what I found and couldn't figure out what the insurance rep said she couldn't find any of these requirements. Maybe it's something they give the provider and not directly to the patient. Thank you for your help!!

No problem, I'm an insurance agent myself and most insurance fall Center reps are not licensed. I would call again and see if you get a different answer and take fornication the names of who you speak with

Sent from my SM-G920V using the BariatricPal App

"Take fornication...."

ROFL

Sent from my SM-N920R4 using the BariatricPal App

I meant take down lol

Sent from my SM-G920V using the BariatricPal App

Hey everyone! My name is Katie and I'm just beginning this Gastric Sleeve adventure. I went to a required seminar and was given some questions to ask my insurance company. They were: what is the required bmi, how many nutrition visits are required and how many physicians visits. So the insurance company said that these limits didn't exist I just needed a pre authorization for surgery. I contacted the surgeons office to see if this sounded right and they said that the surgeon will tell me the required length or time and bmi. Does anyone have an idea if this sounds right? All the reading I've done I expected to hear 35 to 40 bmi, and 90 days or six months of nutrition and physician appointments. Does this mean my insurance might not have these limits or the surgeons office will tell me the requirements??

Hi Katie! We are in the same boat. I called my insurance and they said there is no requirements just pre-authorization. I'll be seeing my surgeon monday. I have BCBS of IL. It just seems too easy right?!?! I'm going to wait to see what the surgeon says. I will let you know. I wish you luck on your journey :)

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