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Highmark BCBS

Hello,
I just reviewed the requirements from my insurance. I meet all of them however I am unsure how to document past attempts at weight loss. What was your experience with bcbs? How did you document and how far back was required? Thanks!!
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  • SisterWannaSleeve
    SisterWannaSleeve

    Thank you ChellNC! I have my appt on the 24th. Fingers crossed.

  • Diana_in_Philly
    Diana_in_Philly

    @SisterWannaSleeve - my insurance did not have a waiting period, but my surgeon required a minimum of 3 months of counseling with the RDs and compliance with program requirements/education/medical tes

  • SisterWannaSleeve
    SisterWannaSleeve

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

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

  • Author
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.
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

  • 1 month later...
  • Author
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! ???? ????
  • 2 weeks later...
  • Author
Update: i just received insurance approval!!! I have have cardiac clearance next but should still make my feb target. Wooohoooo!!!
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.

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