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BCBS of Alabama

dstgirl11

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ConnieY    9

ConnieY
Posted

I also have BCBS of Alabama.

I live in WV and was denied surgery in December 2016 after having 6 consecutive months of doctor visits. They required me to submit forms stating that I had a BMI of over 40 in the years 2013, 2014, 2015.

I went to 3 different doctors to get these forms. It was difficult.

In the end, I wasn't approved until after the new year 2017 and missed my paid deductible for 2016 (which would have saved me $3,000). Now I'm waiting on my huge doctor bill to come in the mail

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Martinichic    39

Martinichic
Posted

I also have BCBS of Alabama.

I live in WV and was denied surgery in December 2016 after having 6 consecutive months of doctor visits. They required me to submit forms stating that I had a BMI of over 40 in the years 2013, 2014, 2015.

I went to 3 different doctors to get these forms. It was difficult.

In the end, I wasn't approved until after the new year 2017 and missed my paid deductible for 2016 (which would have saved me $3,000). Now I'm waiting on my huge doctor bill to come in the mail

????Sent from my iPhone

The same here my 6mth visit was in Dec but the surgeon office said it had to be 180 days for them to even think of approval so I did 7 visits and then got denied because they said my BMI was to low in 2013 but I had pneumonia that yr ughh now waiting on a Dr note I should hear something by the end of Feb if not I have to start the this g all over again and wait till next Feb which don't make sense

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ConnieY    9

ConnieY
Posted

Oh wow Martinichick, I'm really sorry for all that. This insurance does give ya a run around.

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Martinichic    39

Martinichic
Posted (edited)

@ Connie Y . Yes they do give you the run around ,I didnt think that 3 yrs ago when I was sick would affect how my weight is now ,now im waiting again becasue the Dr.office called me Monday and was a little confused when she got her c.c. and BCBS is saying now it was denied becasue she never sent over the physical paper from the surgeon and that she has to resubmit it .So know its a wait and see game for a couple of weeks :51_scream::51_scream:

Edited by Martinichic
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dstgirl11    22

dstgirl11
Posted

After I was denied because of not producing records from 2013, they want a letter from PCP and pictures. I finally got the my primary care doctor yesterday and took it to the surgeon office today. I am waiting to see what they will come up with next. Did anymore hear that they are BCBS is going to be stricter when it comes to weight loss surgery?

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Martinichic    39

Martinichic
Posted

On ‎2‎/‎15‎/‎2017 at 7:36 PM, dstgirl11 said:

After I was denied because of not producing records from 2013, they want a letter from PCP and pictures. I finally got the my primary care doctor yesterday and took it to the surgeon office today. I am waiting to see what they will come up with next. Did anymore hear that they are BCBS is going to be stricter when it comes to weight loss surgery?

I am right there with you on this as we speak, and it kills me that we pay all this money into BCBS and can never get what we truly need out of them. But only waste our money on all ourhigh co-pays and such and do our part to stay fit and healthy, but then we get denied for various reasons but in all reality we are saving them money in the long run. I will never get it I guess.I have not heard of them stricter but you never know .

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Martinichic    39

Martinichic
Posted

Finally got Approved:D my surgeons office had to do a provider appeal and now I'm off to my BEGIN class next week then just wait for that clearance one step closer to a new journey ,Its a lot of work and paperwork and stuff but after I thought about just up and forgot about I got that call ,

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Syaniya    319

Syaniya
Posted

Congrats!!!



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dstgirl11    22

dstgirl11
Posted

Finally got approved last Thursday!!!

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Go To Topic Listing Insurance & Financing

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    • Doughgurl

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      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
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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.
      · 1 reply
      1. LeighaTR

        LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • 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.

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        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.

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