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I have an appointment with a bariatric surgeon next week. Does anyone have any experience with getting approved with Blue Cross of Illinois ? My BMI is 38 and I have recently torn my meniscus . My A1C is 6.2 so I’m not sure if they will approve me or not ?
Thanks

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I have BCBSIL and just went for my first appt. last week. From what I understand, you have to check that bariatric surgery is covered on your specific policy. If it is, a BMI between 35 and 40 requires you have other health issues such as diabetes or high blood pressure. Before I went to my appointment, the surgeons office checked my insurance coverage for me, which was very helpful.

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My *** plan covers 100% for BMI 40+. For BMI under 40, a person needs to have 2 well documented comorbidities. All surgery patients have to go through Psych evaluation, 3 months (4 appointments) of supervised medical weight loss, an upper endoscopy, visit with dietician, 2-3 weeks of liquid diet (dependent on BMI) and anything else that may come up (I had to see a vascular specialist because I have blood clotting disorders). I have done everything through my surgeon’s office - so easy and they are really nice. I am 2.5 months in on the supervised medical weight loss and having my endoscopy and dietician visit next month. Should be good for surgery in Sept or Oct, depending on COVID and the schedule of my surgeon (they had over 3,000 surgeries to reschedule after the first outbreak of COVID). I will submit to be approved once I complete everything. Hope this helps!

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I was at 39. It went thru pretty easy because I had a history of high A1c, borderline blood pressure, and sleep arena. None of the three were severe, but they still helped get it thru. The one issue I did have was they sit on the request for some time. I had to keep calling the MCM to get them to review my file in a timely manner.

Eddy Blaine Brown II

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