Jump to content
×
Are you looking for the BariatricPal Store? Go now!

BCBS-IL ????'s



Recommended Posts

I was wondering if anybody had experience with the 6 month Dr. supervised diet required prior to approval of the lap band. The wording in my plan states that you must have been on a Dr. supervised weight loss plan for at least 6 months in the last 2 years. So.....starting in April of 2007 I started seeing a doctor for about 5 months. I then stopped for 3 months, started again for another 4 months and then saw him off/on over the last year. I saw him a total of 16 times in a 20 month period but never for 6 months straight?!?!?! I've read a lot of the posts and looks like it just kind of depends on the provider but I submitted my documents three days ago and am starting to get a little ansty.....

Thanks for all the help.

Share this post


Link to post
Share on other sites

I was approved with BCBS-Il with a 6 months plan that had been done in 2006, but my plan didn't really specify whether it had to be 6 months straight. I was lucky enough to have seen my doctor at least once in each of those 6 months so I didn't have to find out. You might want to call and ask about it. I am wishing you the best, and that you get a quick approval.

Share this post


Link to post
Share on other sites

My insurance was BCBS IL also and I was told by the nurse through the insurance company that the 6 month PCP visits had to be in a row. My surgery was approved within a few days. GOOD LUCK

Share this post


Link to post
Share on other sites

Thanks for the info.....I should hear back next week so I'll let you'all know what I find out.

Share this post


Link to post
Share on other sites

I'm just starting this process and I posted something in the pre surgical thread. I guess it should have been here. I also have BCBS IL and I wondered if I would have to be enrolled in a specific plan for 6 months or if I had 6 doctors appointments in 6 months concerning my weight and she advised me on options during the visit would qualify.

Share this post


Link to post
Share on other sites

My surgeon's office is really great about finding out exactly what the insurance company requires in order to get approval. I have BCBS-IL and had to do six months supervised visits in a row. I've got two more to go. From what I'm hearing, in the past year BCBS-IL has gotten a little more forgiving in terms of approval, assuming you do follow all of their guidelines. I would find a surgeon or hospital well-versed on BCBS-IL insurance and they'll be sure you cover all of your bases.

Share this post


Link to post
Share on other sites

stacy-

From what my surgeon said, sometimes a PCP doesn't put all of the necessary information in your file that would help with submission. I tried to use my PCP visits (which were specifically for obesity) to count towards my six visits, and there wasn't enough information for them to use towards approval. If you're not going to use your surgeon's office for the six month appointments, make SURE your PCP has EXACTLY what the insurance company needs, so you are 100% sure you've submitted everything you can to ensure approval.

Share this post


Link to post
Share on other sites

Got it.........Just got a call from the Surgeon's office and BCBS approved the surgery!!!!! Looks like they can't get me in till the 1st week of March so I have a month to wait but at least it's gonna get done. Thanks for all the support and I'll keep everyone updated on the progress. YeeHaw!!!!

Share this post


Link to post
Share on other sites

Congrats! I have BCBS IL as well; Just went for my first consult Dec 30th. Have had my preliminary visits (2 w/ surgeon, psych eval and nutritionist); now waiting for letters to be submitted to see if they will approve! Also crossing my fingers that they accept the lo-cal plan I went on 8 months ago as my 6 month lo-cal diet.......we will see!

Share this post


Link to post
Share on other sites

Thanks so much Mandilou for your answers. My visits with my PCP weren't always specifically for my obesity, but my doctor always documented weight and blood pressure and we discussed different options, and she wanted to make sure that I was getting excercise, etc. I hope it works!!!

Share this post


Link to post
Share on other sites

Thanks so much Mandilou for your answers. My visits with my PCP weren't always specifically for my obesity, but my doctor always documented weight and blood pressure and we discussed different options, and she wanted to make sure that I was getting excercise, etc. I hope it works!!!

The information that you mentioned is what was used to approve my surgery through BCBS-IL. Good luck!

Share this post


Link to post
Share on other sites

Oh this makes me so excited... I've finished the 6months and I have my psych eval on Friday yes thats tommorow and my Nutrition appt on the 26th..then submittion..i'm praying so hard!!

Just Tired

Share this post


Link to post
Share on other sites

I have BCBSIL as well. My claim was submitted yesterday with all the requirements including my 6 month diet! I am waiting on the decision from my insurance carrier. :biggrin:

Share this post


Link to post
Share on other sites

This thread is great news to me... I kept hearing HORRIBLE things about BCBS-IL, and it's thrilling to know that some of you have been approved in days. I'm still nervous, but with all my ducks in a row, I have a lot more confidence than I did a few months ago about approval. :smile:

I have two more supervised visits to go... one of which will be with my surgeon. But I can't schedule that last appt. until ALL my paperwork is in, which includes my psych eval (which I'm finishing up Monday) and some prior paperwork from another psychiatrist (who is killing me, because she's been out of the office for nearly two months on "personal leave", and her assistant won't send my files without permission from the doc).

Share this post


Link to post
Share on other sites

Best of luck to you all with BCBS-IL. I am having a nightmare with them right now. I qualify in every way they require, but they declined me because my dr's notes on the 6 month thing weren't "specific" enough. My Lap Band surgeon has referred my case to an obesity law and advocacy attorney. Now I am waiting on that and really starting to get deeply depressed. My doctor has left her practice so if they deny again, I START OVER!!!!!!!:smile:

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • vsg.with.sharon

      Hey everyone!
      I’m new here! Looking for some friends! 🥰
      · 0 replies
      1. This update has no replies.
    • LeighaTR

      Four days post surgery. I am sipping as fast as I can and getting NO WHERE near the goal of 60 - 80 grams of protein or the 64 oz of liquids. I just feel FULL. I don't know if it can still be the gas build up (I would think by now that would be gone) but it is a struggle to drink. And so far I have not had the nausea or spasms and don't want to wander into that territory by pushing too hard with liquids. I about passed out today as it was my most "strenuous" day. Went from second story to basement for shower and I was sure I was going to pass out. Looking back on my last few days I have had a total of less than 1000 calories. Am I just not getting enough nourishment in me? Once again a friday where I can't get ahold of the doc until Monday rolls back around so I am hoping maybe someone here has some experience on how to keep energy going. I do have fibromyalgia too and that may be where some added fatigue comes into play. How did you all fair with the goals the week after surgery?
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      2 days until I fly out to San Diego to have my Bypass Surg. in Tiajuana Mexico. Not gonna lie, the nerves are starting to surface. I don't fear the surgery itself, or the fact that I'm traveling alone, but its the aftermath that I'm stressing about the most, after this 8 week wait. I'm excited to finally be here, but I am really dreading the post surgical chapter. I know its going to be tough, real tough and I think I'm just in my head to much now that the day i here. Wish me luck, Hopefully I'm one of the lucky ones, and everything goes smoothly. Cant wait to give an exciting update,. If there is anyone else have a June bypass or even a recent one, Id love to have someone to compare war stories with. Also, anyone near San Antonio Tx? See ya soon with the future me. 💜
      · 3 replies
      1. Phil Penn

        Good Luck this procedure is well worth it I am down to 249.6 lb please continue with the process..

      2. Selina333

        I'm in Houston so kind of near you and had the sleeve in Dec. Down 61 lbs. Feeling better. Was definitely worth it. I hope the everything is going well for you. Update us when you can!

      3. Doughgurl

        I am back home after my bypass surgery in Tiajuana. I'm post op day 4. Everything went great! I guess I'm one of the lucky ones who have not encountered much pain at all, no nausea thus far and I'm having no problem keeping down broths and water. Thank you for your well wishes. I cant wait to keep up this journey and have a chance at better health and simply better quality of life. I know there will be bumps in the road ahead, and everything won't be peaches and cream, but at least I have a great start so far. 😍

    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

      2. Doughgurl

        Thank you so much for your well wishes. I am hoping that everything goes easy for me as well. We don't eat out much as it is, so it wont be too bad in that department. Thankfully. Also, I hear you regarding your back and feet!! I'd like to add knees to the list. Killing me as we speak! I'm only 5' so the weight has to go. Too short to carry all this weight. Menopause really did a doosey on me. (😶lol) My daughter also lives in Houston. with her Husband and my 5 grand-littles. I grew up in Beaumont, so I know Houston well, I will be sure to keep in touch and update you on my journey. I may need some advice in the future, or just motivation. Thank You so much for reaching out, I was hoping to connect with someone in the community. I really appreciate it. 💜

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×