Highmark BCBS

[mousecat88 2,279]

On 9/24/2018 at 5:29 PM, SisterWannaSleeve said:

Ugh I’m so discouraged! I saw my surgeon today and he said that 6 months of dr monitored diet is required pre surgery. He said it was an insurance requirement. I feel like I should ask again. Thoughts?

I have Highmark BCBS. They did not require any documentation of weight loss OR a monitored diet. All I had to do was make a list of all diets I have previously tried. They approved me no questions asked on the first run. Are you sure it's an insurance requirement and not your doctor's? Are you in West Virginia?

[AJP 132]

Same here. Only requirement Highmark had was a psych eval. Most of the requirements I had to meet were of the doctors office

[SisterWannaSleeve 61]

Update: I’m currently waiting to hear back from my co workers surgeon (no 6 month waiting period with him) and researching Mexico in the meantime. I am learning towards saying to hell with it and going with Dr Ariel Ortiz at OCC...

[PALOMABELLA 45]

Ugh I’m so discouraged! I saw my surgeon today and he said that 6 months of dr monitored diet is required pre surgery. He said it was an insurance requirement. I feel like I should ask again. Thoughts?

U can maybe change your insurance

Sent from my LGMS210 using BariatricPal mobile app

[Jenwill630 119]

On 9/24/2018 at 5:29 PM, SisterWannaSleeve said:

Ugh I’m so discouraged! I saw my surgeon today and he said that 6 months of dr monitored diet is required pre surgery. He said it was an insurance requirement. I feel like I should ask again. Thoughts?

You don't say which Highmark BCBS product you have.

I am switching over to Highmark BCBS Delaware come the first of the year.

Them AND PA both changed their requirement in September where you no longer need the 6 months. I verified this through my surgeons coordinator, a person on one of my FB groups that works at BCBS and I looked for myself on highmarks website....toward the bottom of the page, click on Medical Policy and then search Obesity. I "think" it might be G-24 or G-25.

[SisterWannaSleeve 61]

Hey Jen
I’m unsure which product I have BUT my new surgeons office confirmed I won’t need the 6 month waiting period. I need:

Letter of medical necessity
Appt with nutritionist
Psych eval

I saw the same thing on the medical policy which is what made me ask around.

[Jenwill630 119]

14 hours ago, SisterWannaSleeve said:

Hey Jen
I’m unsure which product I have BUT my new surgeons office confirmed I won’t need the 6 month waiting period. I need:

Letter of medical necessity
Appt with nutritionist
Psych eval

I saw the same thing on the medical policy which is what made me ask around.

I've got the same thing!

I'm so glad this worked out for you....and for me too! LOL

[SisterWannaSleeve 61]

Just saw the surgeon yesterday. His name Dr. Marema in Orlando Fl. He is awesome! The insurance specialist confirmed this AM that she is submitting me for approval. Should only be a few short weeks! 🙏🏼🙏🏼 🤞🏼🤞🏼

[SisterWannaSleeve 61]

Update: i just received insurance approval!!! I have have cardiac clearance next but should still make my feb target. Wooohoooo!!!

[mousecat88 2,279]

19 hours ago, SisterWannaSleeve said:

Update: i just received insurance approval!!! I have have cardiac clearance next but should still make my feb target. Wooohoooo!!!

Highmark BCBS is the best. Definitely the easiest insurance I've ever had to deal with. Glad you found a new surgeon that knows what's up.