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BCBSIL Insurance questions

Samantha89

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Samantha89    2

Samantha89
Posted

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

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sleevinpops    303

sleevinpops
Posted

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?

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Samantha89    2

Samantha89
Posted

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 :)

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sleevinpops    303

sleevinpops
Posted

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!

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jennifer1    180

jennifer1
Posted

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!

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Samantha89    2

Samantha89
Posted

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!

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sablebby    6

sablebby
Posted

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 :(

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

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sabrinamena    3

sabrinamena
Posted

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

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shortyp79    58

shortyp79
Posted

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....!!

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shortyp79    58

shortyp79
Posted

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

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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
      1. This update has no replies.
    • 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
      1. This update has no replies.

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