BCBS NY requirements

[ShaynaC 1]

Hello! I would like some info and experience with people having BCBS in Upstate NY ( Medicaid too ).

What were your pre op requirements, especially with a BMI over 50.

If you had a BMI of 50 or higher did you have 6 month weigh ins? Does everyone have to have the endoscope? please fill me in! my consult is March 12th and of course I'll find out more but just looking for input! Tia.

Edited March 4, 2018 by ShaynaC
Typo.

[dgirl1229 36]

Hello! I would like some info and experience with people having BCBS in Upstate NY ( Medicaid too ).
What were your pre op requirements, especially with a BMI over 50.
If you had a BMI of 50 or higher did you have 6 month weigh ins? Does everyone have to have the endoscope? please fill me in! my consult is March 12th and of course I'll find out more but just looking for input! Tia.

I have bcbs. I did 4 weigh in, endoscopy, pulmonary, cardiologist, nutrition, pysc, and sleep apnea test. BMI is 40. Having my surgery on march 12. It seems like a lot but it goes by really fast. I remember when I started dreading all the BS but now it's here and I can't wait!!

[LadyJC 17]

Hello! I would like some info and experience with people having BCBS in Upstate NY ( Medicaid too ).
What were your pre op requirements, especially with a BMI over 50.
If you had a BMI of 50 or higher did you have 6 month weigh ins? Does everyone have to have the endoscope? please fill me in! my consult is March 12th and of course I'll find out more but just looking for input! Tia.

Yes I had yo do 6 months of weigh-in. I did have to reschedule a few but if you can help try not to that will just push your actual surgery day out further. I live NYS and have BCBS their requirements is that you attend all nutrition appt. and at least 6 weigh-in. If you lose during the process and gain as long as you do go back your original weight from your first weigh then you fine. They want to see that your trying and taking it seriously. You have to go through a psychological evaluation, they want to make sure you don't have any underline issue that would cause to you fall off and regain the weight back.They also want to find out if have a support system. They basically determine what type of relationship you have with food. They also want to know why you decided to get surgery and what plans you have after for maintaining it. They pretty much read between the lines to see if your mentally ready for it. They'll let you know on the spot if they approve you or not. The nutritionist is stern but not intimidating. At the end of thy day they're all on your side. After you've finished meeting with the nutritionist and they give the okay and the psychologist give you the okay you'll receive a call saying that your approved. Tip: Start eating better and getting in what ever physical activity you can it shows them that your serious. Also they're going to ask you what have you been doing to try to loose weight they don't care if you went to fat camp at 13 or tried the cabbage diet it or you used to take Xenadrine... tell then they want know that you've been trying and surgery is nor just an "easy way out"

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[ShaynaC 1]

Thank you for that really long, but super helpful response!!

[abefroman329 704]

It’s probably going to vary plan by plan and practice by practice. That being said, if you’d been seen by my surgeon, you would’ve had to have been on a pre-surgery liquid diet for a longer period of time than someone with a lower BMI, and might have had to go in for blood work while you were on the pre-surgery diet.

All plans and practices seem to require some form of supervised medical weight loss program and a psych evaluation, as well as a screening for sleep apnea if you haven’t already had one. Also, though I haven’t heard it mentioned here, my surgeon requires that patients get their A1C below 7 before surgery.

[CTGirl08 10]

I recently switched insurance companies, but I had BCBS of Western NY when I started this process. Requirements were 6 months of nutrition visits, 1 psych eval and 1 exercise class. No endoscopy.