Question:
Blue Cross Blue Shield of Il PPO how long has it taken?
I am 321 with a BMI of 53 and am wondering how long it has taken for my insurance to approve surgery? I am in Modesto, Ca and would really appreciate any feed back. Thanks — awaiting_the_new_erica (posted on September 14, 2008)
September 14, 2008
I also have this insurance. I had to do a 6 month diet and a physc eval. I
am in my last month of my diet. I have been told that once my papers are
received by them it will take two weeks for them to review and give me an
answer. Good Luck.
— pugsley101
September 14, 2008
I have BCBS of PA and also had to do the 6 months supervised diet, but once
paperwork was sent in, it only took 1 week, and the insurance co. called me
before the doctors office did, what a suprise that was. Good Luck.
— [Deactivated Member]
September 15, 2008
I have united. They did not required weight loss up front.
but did require a pshy elvation.
I was told once all the requirements are in and presented to
the Insurance co. it would take 4-6 weeks for their decision
good lock
— BJW12
September 15, 2008
I have BC/BS POS and it only tool 4 weeks for approval. My stats were
similar to yours.
— pattschiele
September 15, 2008
I have Blue Cross Blue Shield of Texas and live in Stockton, CA. I'm
thinking we may have the same doctors located in Modesto. Once all of my
required paperwork was submitted to the Doctor's office and it was finally
submitted by them to BCBSTX, it took only two days for my approval. I was
223 LB with a BMI of barely 41. My delay was from within the Doctor's
office. I would not hesitate to call both your Doctor and the Insurance
Company. I would start with the Insurance Company, they will let you know
if it has or has not been received. If they have not received it, contact
your Doctor's office and keep calling. Mine told me it had been submitted
when it had not. I had my surgery on 04/11/08 and have lost 67 LB and am
still losing (probably slower than those with a higher start weight. I have
no regrets. Good luck!
— grobertsjenkins
September 16, 2008
I have BC/BS of IL and it took 48 hours for my approval. I called the
first day to see if they got it and they did, then I called the next
morning and they said it was approved. I had to do the 6 months of doctor
supervised dieting, weighing in, and talking to a nutrionist each month,
and the psych doctors approval. It flew by when I think about it now at 5
months out. But when you are in the process it does seem to move slower.
I am down 101#'s in that 5 month time. Thanking God daily
— usfour
September 16, 2008
I have BC/BS of IL and it took 48 hours for my approval. I called the
first day to see if they got it and they did, then I called the next
morning and they said it was approved. I had to do the 6 months of doctor
supervised dieting, weighing in, and talking to a nutritionist each month,
and the psych doctors approval. It flew by when I think about it now at 5
months out. But when you are in the process it does seem to move slower.
I am down 101#'s in that 5 month time. Thanking God daily
— usfour
September 21, 2008
It took BCBSIL a year to approve me. It involved doing 6 mos of supervised
dieting (MEDICALLY supervised so I had to pay out of pocket for a
dietician) as well as years of medical history documenting obesity and
weight loss attempts. I also had to have co-morbidities (diabetes, PCOS,
infertility, sleep apnea or insomnia, etc.....) which I did. I originally
wanted the lapband and changed my mind 9 months into it all and I think
they are approving RNY faster - perhaps because it's more proven to work -
and they approved me right away, the first time I applied for the RNY. (I
had been denied lapband 2-3 times in that year). It was a pain but they
have been really good with covering everything since I got approved.
— Fluffee
September 21, 2008
I live in Cotati, CA (Sonoma County) and I'm just about the same size as
you. It took me about a year and a half to get approved from BCBSIL. I had
to do the 6 month medically supervised diet, Nut and Psch evals. I made my
own form for the Doc to fill out every month as BCBSIL does not give
specific guidelines for the doc. Then they told me the information wasn't
complete enough from the doc. Then they told me that I didn't supply enough
medical history. Then they told me that Jenny Craig was not an acceptable
diet, when it was right there in black and white on my policy details (READ
your policy specifics for Bariatric coverage). Stall...stall...stall... I
kept notes of every conversation, person's name, date and time. Finally as
all of my reqired info was about to expire (had a 2 year window BCBSIL PPO)
and I had jumped through multiple hoops at their request- I told them that
they were almost being cruel and maybe I needed to talk with an attorney. 2
days later I was approved for Lap RNY. I'm not going to sugar coat it- I
cried and got very frustrated often. They made it pretty darn difficult
because in my opinion, they didn't want to pay for the surgery- period.
Good luck and if there's anything more you want to know, drop me an email.
— Lynda G.
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