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Highmark BCBS PA

Anyone have issues getting approved?

  • Replies 14
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  • Misha42000
    Misha42000

    I didn't know there were 2 stages of approval. I only have my psych eval left and then my surgeon's office is going to submit everything to Highmark BCBS of PA for approval. I did confirm th

  • beege42
    beege42

    Just had surgery and I have highmark BS here in PA. Finished the 6 mo nutrition classes and psych eval plus other clearances. I was worried cause bmi was 38 and my other health issues were all borderl

  • I have Highmark and was approved in March and had no problem. It took under a week. Good luck![emoji256]

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I have Highmark and was approved in March and had no problem. It took under a week.

Good luck![emoji256]

  • Author

Did you have to do a 6 month supervised diet and how long did it take you to get approved once you submitted your paperwork?

My dr office didn't know that Highmark changed their policy about the six month wait, so four months in I found out about the change thanks to this forum! I called the office and they submitted my paperwork right away. I believe it was less than a week to get approved. I received the approval from Highmark via mail and had to let the office know.

  • Author

Thats great news.

That's who I have. I'm just in the early stages of my journey. I was pre approved through the insurance but the final approval has not happened yet.

  • Author

I didn't know there were 2 stages of approval.

I only have my psych eval left and then my surgeon's office is going to submit everything to Highmark BCBS of PA for approval.

I did confirm that in 12/16 they decided to get rid of the 6 month supervised diet :)

I did not have a pre approval. Perhaps it depends on the particular plan. I have Highmark commercial through my husbands employer here in Erie. The only thing I did was to call Highmark to make sure they covered gastric surgeries. After that, the doctor's office took care of the rest.

I was sooooo happy that they dropped the six months!!




  • Author

I'm praying it will be approved for me as well.

I guess I said it wrong. They called BCBS and they said they covered the surgery. It's not really a pre approval. I miss spoke. Sorry. :huh:

Just had surgery and I have highmark BS here in PA. Finished the 6 mo nutrition classes and psych eval plus other clearances. I was worried cause bmi was 38 and my other health issues were all borderline with little treatment or medications to date but it was approved in 3 days and I had surgery last week! One hospital said I wouldn't get approved and I went through another hospitals weight loss center last august and now I'm post op!


  • Author

I thought they didn't require the 6 month nutrition classes.

I hope not. I was hoping to get the surgery in July.

  • Author

I did check and they revised the medical policy G-24 for gastric sleeve on December 2016 and they No Longer require the 6 month supervised diet.

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