Jump to content
×
Are you looking for the BariatricPal Store? Go now!

BCBSIL Insurance questions



Recommended Posts

Hey everyone.. I finally have some decent insurance through BCBS IL. I called them and they told me

all I have to do to qualify for surgery is have my doc submit a pre-authorization.. yet I keep reading different things. It's really hard for me to believe it would be that simple. I do have my first appointment on Monday 01/30/17 with my doc, super excited to start. I found a snippet in the medical policy saying 6 months of supervised diet is no longer required. I guess I will Find out Monday! If anyone has any info that would be greatly appreciated!

bcbs.pdf

Share this post


Link to post
Share on other sites

Each is different, I had a 6 month supervised and initially hoped it were sooner, I am now great full as I have been able to get my mind and self really ready for this. Our life and old habits are gonna change, and the time allows for us to be really ready to make sure we will maintain.

Now only two weeks away, the first 6 months flew, but feels like forever on the next 2!

Good luck on your journey! Hope to read about your progress?

Sent from my iPad using the BariatricPal App

Share this post


Link to post
Share on other sites

Each is different, I had a 6 month supervised and initially hoped it were sooner, I am now great full as I have been able to get my mind and self really ready for this. Our life and old habits are gonna change, and the time allows for us to be really ready to make sure we will maintain.

Now only two weeks away, the first 6 months flew, but feels like forever on the next 2!

Good luck on your journey! Hope to read about your progress?

Sent from my iPad using the BariatricPal App

Thank you so much! I have been trying to get the surgery done since 2014, was almost approved then my insurance company (not BCBS IL) changed requirements. I got a new job and didn't want to take off too much time too soon so it looks like now is a great time. My boss is fully supporting me. I have been able to take off about 50lbs since July so I'm really trying here!! My mother also had bariatric surgery years back, so I feel like im pretty ready! Thank you so much! I will update when it happens :)

Share this post


Link to post
Share on other sites

That's great! I didn't know the history, but sounds like your ready to go! You may be able to shorten the time if you can show that you have been actively working on a weight loss goals. Check with your PC he can probably recommend too.

You got this!

Sent from my iPad using the BariatricPal App

Share this post


Link to post
Share on other sites

i have BCBSIL and i saw that about not having to do the 6 month diet, which is true. HOWEVER, i have a lap band and im trying to get it removed and revised to the sleeve. i have been denied twice, basically due to paperwork. they first said my paperwork didnt show it was medically necessary to have my band removed, then we submitted with more paperwork. Now they are saying they thought my band was removed in July so they denied me again!! Currently they are reviewing my paperwork AGAIN!!! So i would just advise that all the documentation they request is submitted correctly!!! Best wishes to you!

Share this post


Link to post
Share on other sites

i have BCBSIL and i saw that about not having to do the 6 month diet, which is true. HOWEVER, i have a lap band and im trying to get it removed and revised to the sleeve. i have been denied twice, basically due to paperwork. they first said my paperwork didnt show it was medically necessary to have my band removed, then we submitted with more paperwork. Now they are saying they thought my band was removed in July so they denied me again!! Currently they are reviewing my paperwork AGAIN!!! So i would just advise that all the documentation they request is submitted correctly!!! Best wishes to you!

I sure hope they get your paperwork corrected ASAP and you can get your revision, it's so frustrating!

Share this post


Link to post
Share on other sites

I have BCBSIL, they submitted my pre-authorization on Dec. 12 and was approved on Jan. 9.

Looks like it's going to still be about $10,000 for me though so we haven't set a date :(

Sent from my iPad using the BariatricPal App

That's you paying just about the full amount...what is your deductible if you don't mind me asking

Share this post


Link to post
Share on other sites

I have BCBSIL, they submitted my pre-authorization on Dec. 12 and was approved on Jan. 9.

Looks like it's going to still be about $10,000 for me though so we haven't set a date :(

Sent from my iPad using the BariatricPal App

That's you paying just about the full amount...what is your deductible if you don't mind me asking

My deductible is $750 and my out of pocket is $7,150. Co-insurance is 75/25. I'm honestly kind of confused with all of it!

Sent from my iPhone using the BariatricPal App

Share this post


Link to post
Share on other sites

Hey everyone.. I finally have some decent insurance through BCBS IL. I called them and they told me

all I have to do to qualify for surgery is have my doc submit a pre-authorization.. yet I keep reading different things. It's really hard for me to believe it would be that simple. I do have my first appointment on Monday 01/30/17 with my doc, super excited to start. I found a snippet in the medical policy saying 6 months of supervised diet is no longer required. I guess I will Find out Monday! If anyone has any info that would be greatly appreciated!

Samantha89 - i have them too. I only needed 1 dr consult, 1 psych consult, and 1 nutritionist consult. I'm just waiting to hear BCBS IL apprive me.... the dr said they usually take longest. Up to 30 days before approving....!!

Sent from my SM-G930T using the BariatricPal App

Share this post


Link to post
Share on other sites

Hey everyone.. I finally have some decent insurance through BCBS IL. I called them and they told me

all I have to do to qualify for surgery is have my doc submit a pre-authorization.. yet I keep reading different things. It's really hard for me to believe it would be that simple. I do have my first appointment on Monday 01/30/17 with my doc, super excited to start. I found a snippet in the medical policy saying 6 months of supervised diet is no longer required. I guess I will Find out Monday! If anyone has any info that would be greatly appreciated!

Samantha89 - i have them too. I only needed 1 dr consult, 1 psych consult, and 1 nutritionist consult. I'm just waiting to hear BCBS IL apprive me.... the dr said they usually take longest. Up to 30 days before approving....!!

Sent from my SM-G930T using the BariatricPal App

....so i'm waiting for approval at this time. Had my psych appt on Monday, Jan 16th... #fingerscrossed

Sent from my SM-G930T using the BariatricPal App

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
    • Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×