ObesityHelp

I have BCBS. Blue Options is the PPO which is what I have. I know the PPO requires a BMI of 40 or greater with no commorbidities, but they will still consider approval for a BMI of 39 with commorbidities. It sounds like you have a few, but list anything like swelling in your legs or back pain for example. My plan is based in Arkansas though, not North Carolina and they might have different requirements. You may just want to call and ask them. One thing that I love about BCBS is that not once have they asked me for my name until AFTER I've explained why I'm calling and nine times out of ten they will answer my questions without asking for my name. All the other insurance plans I've had will get your life history first and then you're afraid they are making notes as you talk. I've found BCBS to be forthcoming and willing to give information and they were fantastic about approval. At the time of my first appointment, my BMI was 44 with minor commorbidities like shortness of breath and borderline high blood pressure. It took a week to get approval. Good Luck! (oh...also ask them if your employer has any limitations or restrictions...after I was approved and had to call them for information I was informed that there was a $5000 limitation on coverage, but when I questioned that they said, "Oh, your employer is the only one in Arkansas that doesn't limit coverage.")

Brandie: OK here it goes - I have BCBS also. It all depends on your last 5 year weight history. You must have been a BMI 40 or greater for the past 4 out of 5 years. You can also be considered with a BMI of 35 or greater with comorbility such as hypertension (on medication) or sleep apnea for the past 4 out of 5 years. Go the www.bcbsnc.com and at the top of the website type in gastric bypass. Click on 2. surgery for morbid obesity and it will show you all the information and requirements you must meet for approval of insurance coverage. GOOD LUCK - hope this answers all your questions.

Thanks for all the info. Susu, thanks for that info. Who is your doctor? I am worried because I am at my highest weight. I have not been at 40 for 5yrs. I have probably been from 35-40. I have lost a little and gained more, back and forth. I have arthritis, depression, shortness of breath. Probably other things, but haven't been checked for them. I am high rish for diabetes because of my weight and PCOS. PCOS is the reason I have gained so much in the last 8yrs and can't loose easily. Plus I still have the eating habbits of when I was small. Anyway thanks for all the info. If I do not have a 5yr weight history what will they do? I plan on contacting the surgeon this week.