Seems to good to be true...

I talked to my insurance company today to see what the WLS policy was for my plan.  She checked the code for VSG and said "It is covered.' like no big deal,  then proceeded to list all the things related to the surgery it will also cover.  I asked about needing to do a 6 month physician recommended diet and she told me that the insurance will pay as long as it is medically necessary, no 6 month anything needed.    

I called the surgeon I am leaning towards using to schedule a consult and to get more information.  I told the coordinator that they have never had a problem with BCBS of MI (my insurance).  

I have NEVER heard of it being this easy.  I am excited, yet waiting for the other shoe to drop.  

Has anyone ever heard of it being easy to get insurance to pay for WLS?  

I have BCBS of Mass. and it was equally easy.  I had a three month supervised diet.   The surgeon scheduled my surgery for 2 weeks after completing the supervised diet, and they had no concern about getting the approval in time.  The NP submitted my paperwork at three months, and it was approved within days. 

I was quite obese, so there was no question that it was medically necessary.  That probably helped.

I wish you well with your weight loss journey.  I hope you are as happy with your sleeve as I am with mine.

Carol

 

Mine was incredibly easy. I have Blue across Blue Shield federal and I only needed a 3 month supervised diet. As well as one meeting with a psychologist , one nutrition visit. Once I sent in paperwork I was approved in a week.  

Simple for us. The surgeon's office coordinated all appts with Psych, PT, NUT, etc. It was probably 2 months start-to-surgery.

I have BCBS NJ and it was also easy...
I needed to do 3 mts supervised diet not 6 mts
Lung, heart, endoscope, psych check and letter of medical necessity
Which is your PCP writing a letter documenting your weight, the WL programs you've tried and any co- morbitites
Insurance co. Are realizing the benefit to THEM in doing WLS it saves them a TON of money in future regarding medicine and complications with co-morbitites ...

I have BCBS-TX and I had no problem with approval~~had no diet to follow and had only a BMI of 39. It was awesome and so easy. Good luck to you!

Thanks for all of the replies!  It is very reassuring to hear others have not had to endure a roller coaster ride with insurance!

My insurance was that easy- I went to an information session at the end of May, my initial consultation with the surgeon was in the middle of June, and I received my approval letter from my insurance company in the beginning of August.

I talked to my insurance company today also, I have BCBS of Alabama PPO, and it seemed pretty straight-forward.  My policy does require the 6 month diet, 3 years of height/weight records, and a letter of recommendation from the doctor and surgeon.  

 

I have my appointment with my doctor tomorrow to start the 6 month diet, and I'm making an appointment with the surgeon next week to do my consultation and make sure I get all of the testing I need.  I'm requesting the doc send a predetermination letter to the insurance company with my medical history of height/weight measurements for 3 years to get the ball rolling.  Good thing is that I have been going to the doc around every 4 mos for anxiety/PMDD/depression and high cholesterol. 

 

Hopefully the the approvals will come through easily. Did they tell you how much of the cost they are covering?

I don't think it's that easy for everyone though, because I've talked to some people who had to jump through hoops.  It just takes a little more time for some, and that's all you can do, just be patient.  Even though my insurance company said they waive 100% of the deductible, I still find myself paying for several things I didn't think I'd have to pay for.