Question:
DOES ANYONE HAVE BSBC OF ILLINOIS?
IF SO, DO THEY REALLY REQUIRE A 6 MONTH SUPERVISED DIET WITH A NUTRITIONALIST? I RECENTLY WAS TOLD THIS AND JUST WANTED TO FIND OUT IF IT WAS TRUE. — Tanya F. (posted on June 30, 2003)
June 30, 2003
Tanya, check with the insurance company. I have BCBS of Illinois and was
told the guidelines vary by policy. The CSR checked my policy for coverage
and sent be guidelines of what was needed for surgery to be covered. It
took less than 24 hours for telephone approval for surgery and my doctor
got written confirmation within 72 hours. They were great to work with.
— plucmn
June 30, 2003
I also found BCBSIL very easy to work with. I changed to BCBSIL just a few
weeks before my surgeon consult because I had fought with my prior
insurance for over 5 months to approve a physician referral (they
eventually approved a referral, but it was to a surgeon that I didn't want
to use). BCBSIL didn't require the supervised diet (though I had
documented many previous weight loss attempts, some medically-supervised,
some not--I don't know to what extent they used that information), and
didn't make me jump through any hoops. I was approved in less than two
weeks after my surgeon consult.
— Vespa R.
June 30, 2003
I too have BCBS of ILL and I am thinking it depends on your policy. They
received my paperwork on a Tuesday and I was approved that Friday and
didn't have to have any other requirements. My girlfriend and step-mom have
the same insurance and my girlfriend has to have 6 months of supervised
diets. My step-mom was approved for the RNY (which she didn't want, they
turned it in wrong) but was denied lap-band and VBG (which she wants the
VBG). So I think it just depends on the particular policy. Good luck in
your WLS journey!!
— Michelle M.
June 30, 2003
Not all insurance companies or policies are alike. I have Health Alliance
of Illinois and they require a 6-month supervised diet. However, if my
employer had an exclusion in their own policy against WLS I would not be
able to have it even if Health Alliance allowed it. Luckily my employer
did not have any exclusions in their policy. I would check your own policy
for any exclusions.
— Checker B.
June 30, 2003
I have BCBS of Illinois, PPO. I just got my approval today (yeah) after
two months of waiting. First, they told me that I didn't need any
supervised diet history. Then, I got denied because they wanted it. Then,
they tried to tell me that I need five years of history. I just kept on
them and sent in letters and documentation of failed diet attempts, etc.
and they approved me. Please feel free to email me if you would like to
see what I provided them with. Best of luck to you!
— kristynush
July 1, 2003
BSBC/HMO-IL covered my WLS in June,2002.When I first inquired of BCBS about
the criteria for qualification, they told me that the Medical Group is the
entity that really calls the shots for qualifying for surgery. So, I
called the Medical Group and got the requirements from them. This enabled
me to be well prepared ahead of time.
— [Deactivated Member]
July 1, 2003
Tanya,
I have BCBSIL through our Local Union 130 and they approved me no problems,
no questions asked within 1 week. No diet history and no major co
morbidities (diabetes, etc)
Good luck!
— kathy B.
Click Here to Return