Who's you're insurance company and what were their approval requirements for the surgery?

My nutritionist walked me through. She had all the insurance info for me. All insurance companies are different. I had to be on a low calorie diet for six months. My friend had to follow a low GI diet for a short amount of time. I had to document behavior changes. I was required to have a phyc exam. I had to see a pulmonologist(sp) and maybe another - cant remember. After I completed it all, I was approved. I found all the requirements at my insurance companies web site. I searched the articles for lap band. Good luck

:cool2:I have BCBS community blue PPO, I went through a bariatric center that was contracted with my insurance company so it made everything so much easier. my bmi was over 50 so that made me not have to have any documentation, just needed a psyche eval..intl consult was 4/7, eval is 4/17...center said that i should be banded by the end of may.

Edited April 11, 200818 yr by new_jewel

I have bcbs of Minnesota and was a cake walk:

1) 6 month dietitian appts

2) Physc eval

The rest the surgeon required. took 1.5 days to get approved after submitting pre auth.

I have one of the UHC PPOs and I needed a BMI 35+ with 2+ comorbidities or BMI 40+ (very standard). That was it.

Does anyone else have federal bc/bs? I have heard it pays the best, anyone out know from experience?

Does anyone else have federal bc/bs? I have heard it pays the best, anyone out know from experience?

Ragdollx19 does I have talked to her in the past.

insurance ---Anthem Blue Cross Blue Shield VA (PPO)

requirements ---a letter of medical necessity from surgeon

APPROVED IN 24 HOURS!!!! :redface:

Cool...thanks for the info guys! I might be getting a new job but I don't know who they have they're insurance with just yet. I'm just trying to get an idea of who has dealt with what company and what their experience was like so when I get my new insurance I might be able to have an idea of what I'm up against again. I just hope this new place doesnt have a dang exclusion like my current job does. Dont even get me started on that....lmao!

I have UHC and they require the BMI of 35+ with at least 2 comorbidities. Do you know if they will still approve a person who is hovering at 34.9-35.3 with 3-5 comorbidities? I know it varies from division - division. I'm just wondering how anal they are about the BMI.

Thanks,

Melissa

Hi ya'll! Just joined this thingy and am keeping my fingers crossed that Blue Shield of CA will make me a happy girl in a couple of weeks. I know that I had to get a phsycological, medical, surgical and dietary evaluation, but no word yet on if I'll have to get the 6 month diet thing. Gosh I hope not!! I've been going to weight watchers for years, but never was able to stick to it. I tossed all the books I had, and simply don't have records of all the other diets I've tried. I did a weight loss thing with a doc in Vegas when I lived there, but I don't think he's even around anymore. Does anyone have any experience with BS of CA PPO? Please tell me that it was okay and didn't require 6mo of diet records. My BMI is 41 and I have arthritis, bursitus, along with ruptured discs in the back, sleep apnea, depression, and more. No high blood pressure or heart disease, although it's in my family. Someone tell me that BS of CA will be easy!!! I'm worried!

I was approved yesterday for the lapband proceedure!! Now I'm scheduled to have it done on June 6th!!!!!:smile2:

Way to go, Peace Dove!

I am so happy for you! You go, girl!!

Congratulations!

Melissa:tt2:

I'm with United Healthcare.

I needed the psych eval (which is standard with my surgeon anyway). Their requirement with no comorbidities is BMI above 40, I just made it with a 41. My surgeon submitted the required information and I was approved in about a week and a half.

:tongue2::grouphug::grouphug:Congratulations, Jodi!!!

I truly hope I have the same success and luck as you with United Healthcare. I really do. However, I'm scared to death I won't, since my BMI is under 40. Don't get me wrong. I have several comorbidities. I just don't have the 5 yr. PCP 5 yr. documented BMI/weight history. I had my Chiropractor submit a 5 yr. history. I really hope they accept it. Please pray for me and keep your fingers crosed for me!

Thanks,

Melissa

I will keep you in my prayers Melissa. I know what you are going through, I was on pins and needles while I was waiting to hear back from them.