I was just contacted by my surgreons office on Friday, regarding the requirements for Lapband surgery. I was prepared for lots of work ie..psych appt 6 month dr weight loss even a nutrionist and 5 year history of morbid obesity, but she seemed discouraged already. She told me that if you go below the 40 BMI during that 5 year period you are automatically excluded. I was shocked and got onto the bcbsil website and read the medical policies on the srugery. It did not say that you could not drop below 40 BMI. I read it as they just wanted to make sure you had weight issues for years not just a short period of time. She continued to state in 2 1/2 years she had gotten only one approval from this particular insurance co. I was getting discouraged, then later in the conversation she proceeded to tell me that honestly when most people find out about all the guidelines and the 6 mo diet they choose to go the self pay route. I think if it is worth doing you have to put some work into it, and that is what my insurance is for! I pay good money for it and think it is worth a shot to get all my stuff together and submit it. I was really just wondering if there were any experiences with this insurance and what was the outcome. Thanks for any advice you have. Tamara

It is obesitylaw.com. Just go on and you can either email or give them a call.

Good -Luck!

It is obesitylaw.com. Just go on and you can either email or give them a call.

Good -Luck!

Thanks for the info. I can only hope that I never actually have to use it.

I got approved!!!!!!!:smile2::thumbup::thumbup:

Congratulations!! You will have to let us know your date! I think BC/BS is on a roll!! Tamara

I got approved!!!!!!!:crying::thumbup::wink2::thumbup:

That is awesome!!! And that was really quick! :wub: Congrats!!

I hope mine is that quick and that I get some good news. I decided to call yesterday but it hadn't been reviewed and they told me that it usually takes 7-10 days. I'll letcha know what I hear, but best of luck with your surgery!!

That is awesome!!! And that was really quick! :thumbup: Congrats!!

I hope mine is that quick and that I get some good news. I decided to call yesterday but it hadn't been reviewed and they told me that it usually takes 7-10 days. I'll letcha know what I hear, but best of luck with your surgery!!

I called everyday. I think they finally got tired of hearing from me. I got my surgery date today!

Good luck to you too. I hope you hear something soon!

I got approved!!!!!!!:thumbup::thumbup::thumbup:

Woo Hoo!!! I am so glad you didn't have to go through all the bs to get it. Let us know when you have a date. CONGRATULATIONS!!!:cool2:

Help! My paperwork was faxed to Empire-BCBS on the 20th. I called on the 26th to check on the status and was told that its was on the medical review desk. this morning i get a call from them that i was denied. because my BMI is 38.5 and i have no uncontrolled comorbilities. I have high blood pressure which is curently being controlled by medicine and relaxation technics ( this month that is).

she said that i could - call to have it recinsdidered, have a peer reivew or appeal. I don't know what the reconsideration or peer reiview intells? can anybody give me any info??

i have called my surgeon's office but they are not always good about returning phone calls and BCBS said i had 10 business days to take action.

My doctor's office also said that we only had 3 appeals and i would hate use them with not knowing what i needed to do.

any advice???

My family history has strokes, high blood pressure and congestive heart failure for both of my parents. i don't want to end up like they have.

or do i just try to gain the 10 to 15 lbs that i would have to have to met the BMI of 40? and if i do that would that flag something with BCBS?

or are they just trying to see if i'll give up?

they didn't say anything about having to have a BMI of 40 when i called to see what the requirements were.

I'm not giving up if that's what they think saying no will do!!

You are right, they just want you to give up. If I were you, I would have your surgeon request a peer to peer. If it is still denied you could contact Obesity Law at www.obesitylaw.com, and let them handle it. That is who I used. You can go online and fill out a form and they will contact you and tell you what your options are.

Woo Hoo!!! I am so glad you didn't have to go through all the bs to get it. Let us know when you have a date. CONGRATULATIONS!!!

10/2/08!!! WOOHOO!:biggrin:

Ughhhh,

After two denials, I am now working on it yet again with BCBSIL. I am so aggravated and I almost feel like just giving up. I was denied the first time because "I didn't include my 6 months preop diet"....even though I pointed out that it was on pages 21 and up. So they reconsidered after I resent it....then I was denied on 8/28/08 because my diet info was "limited"...this is really getting to me. It's now September 16th and I am just coming around to dealing with it bc getting two denials has been so disheartening. I am having my doctor rewrite my six months, but this is just ridiculous. I just want to be thin and healthy.....

You can do it! I have been working on this since 11/07 and will be banded tomorrow with BC/BS Illinois. They have been on a roll with approvals you just have to be a pain in their butts and call everyday. Good luck! Tamara

Ughhhh,

After two denials, I am now working on it yet again with BCBSIL. I am so aggravated and I almost feel like just giving up. I was denied the first time because "I didn't include my 6 months preop diet"....even though I pointed out that it was on pages 21 and up. So they reconsidered after I resent it....then I was denied on 8/28/08 because my diet info was "limited"...this is really getting to me. It's now September 16th and I am just coming around to dealing with it bc getting two denials has been so disheartening. I am having my doctor rewrite my six months, but this is just ridiculous. I just want to be thin and healthy.....

Contact ObesityLaw @ www.obesitylaw.com, and they may be able to help. If you qualify, they can direct you to on how to get their help for free.

I WAS APPROVED YESTERDAY!!! WOO HOO, NO DATE YET, BUT I'M ON MY WAY!!!:huh2::thumbup:

Congrats! I remember the excitment. Keep in touch and let me know how your progress goes. I was banded July 29th of this year and Ive been unable to get my fills for over 2 months now.Im holding my own but its hard being hungry all the time. Im hoping to get a fill this next week.! Lost 50 and been stuck for these last 2 months.Leah