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BMI 39-bcbs of north carolina

I have been thinking about the lapband for quite sometime now. I went to an orientation last week and I am very interested in the lapband. I have only one concern, I have BCBS of North Carolina and I'm not sure if I'll get approved as my BMI is only 39. I'm 5' 1/2", 204 lbs with no health problems. I have tried every diet there is and yet like others have not been successful. I'm ready to change my life, just because I don't have any health problems now don't mean I'm free from them. I'm 41 years old and my mom is morbidly obese and has several health problems. I'm afraid I won't be here to see my grandchildren 1 day. I just don't know what to do, this is driving me crazy.

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Well, I thought that I would be using Dr. Moran in Raleigh but I can't seem to get a call about how much my insurance will even pay. I realize that the holiday may have played a major role in this process and that I am so excited. If I don't receive a call before long I might consider going to another doctor. My emotions on this are rather scrambled right now and don't know which way to go. Maybe I am have not allowed enough time to pass before I should even be considering a change in surgeons. I just want this process to go as smooth as possible. I have already spoke with my insurance company and know that it is covered on both plans.Any suggestions would be greatly appreciated.

Do you have more than one insurance carrier?

Yes, I have BCBS of NC and Mass

  • Author
Yes, I have BCBS of NC and Mass

Good for you. You should be straight then on your coverage. You shouldn't have to pay anything out of pocket. I'm concerned that I'll have to pay my deductible prior to my surgery. I believe that's $600, I just paid $300 for my phych eval. Times are really hard right now. I probably shouldn't complain because there are some whose insurance won't cover any part. I just thank God, for what my insurance will cover.

The physc evaluation was not done through your program. As far as I know I will have to pay for the nut and maybe 55.00 for the physc eval. I just want to know what I need to do so i can get the ball rolling.

  • Author
The physc evaluation was not done through your program. As far as I know I will have to pay for the nut and maybe 55.00 for the physc eval. I just want to know what I need to do so i can get the ball rolling.

There's another lady on the forum that went through Dr. Enoch's office, she said she had her eval done by a Psych Dr. at Dorothea Dix for $55.00, and she had it done on her own. I'm pretty sure you can contact that physician to schedule an eval to atleast get that portion done.

  • Author

UPDATE!!!! and conflicting stories. I just received a call from my Surgeons Administrator who is responsible for sending the packet to the insurance co., well it has not been submitted yet as she was waiting for a clearance from the Psych Dr. and Nutritionist. I was just told earlier that the packet was already sent to my insurance co and they were waiting on approval, well that hasn't even been done yet.

I have BCBS of NC and the total process took about three and a half months. It took two hours for approval. :biggrin: The waiting is the worse but its worth it in the end. My surgery is July 16th so right around the corner. I'm so excited. Good Luck to all of you and keep updating.

  • Author
I have BCBS of NC and the total process took about three and a half months. It took two hours for approval. :biggrin: The waiting is the worse but its worth it in the end. My surgery is July 16th so right around the corner. I'm so excited. Good Luck to all of you and keep updating.

Thanks for the info, but is that 3 1/2 months including the initial orientation/consultation and all appts etc? Who are you going through to have your surgery done?

Congrats to you. Do you have to pay anything up front before you have the surgery?

Yes, I have to pay $600.00 for my deductible and $60.00 for my regular visit on the 24th.

I finally heard from the doctors office and I will have my consult on June 15 and have to pay a $250 program fee, with both of my insurances I am not sure how much my deductible will be. Hopefully I will be able to go ahead and get my nut eval and physch eval before long. I will probably have to be cleared by my cardiologist also so I will have to do that.At least I know that they are working now on this stuff.

  • Author
I finally heard from the doctors office and I will have my consult on June 15 and have to pay a $250 program fee, with both of my insurances I am not sure how much my deductible will be. Hopefully I will be able to go ahead and get my nut eval and physch eval before long. I will probably have to be cleared by my cardiologist also so I will have to do that.At least I know that they are working now on this stuff.

If you don't mind me asking what is a program fee?

  • Author
I have BCBS of NC and the total process took about three and a half months. It took two hours for approval. :smile2: The waiting is the worse but its worth it in the end. My surgery is July 16th so right around the corner. I'm so excited. Good Luck to all of you and keep updating.

Do you have to pay anything upfront? Like your deductible.

  • Author
Yes, I have to pay $600.00 for my deductible and $60.00 for my regular visit on the 24th.

I was just wondering, because I'm hearing several different stories about paying upfront or being billed. I didn't know you had to pay your total deductible upfront. I had another friend of mine who has bcbs of nc and paid nothing upfront, but got a bill in the mail, that's why I was asking. I was never told though by the dr's office that I had to pay anything but for the psych eval upfront.

I am not sure if the deductible has to be paid before you can have the surgery but I can find out and let you know. I am closer than I have been in my entire life.More excited than anything.

  • Author
I am not sure if the deductible has to be paid before you can have the surgery but I can find out and let you know. I am closer than I have been in my entire life.More excited than anything.

Thanks. I would really appreciate that.

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