Question:
Can anyone with BCBS of Illinois please share their stories with me...

My insurance paperwork will be submitted for approval by the end of next week, and I am really nervous about being denied. I am 23 years old, have a BMI of 45.9, and have some co-morbidities such as joint and back pain, swelling in the extremities, depression, hypertension, and shortness of breath. I have documented history of my weight loss failures, but I have never been "officially" put on a physician-supervised weight loss program. I'm worried that this will hinder the decision. Please share your comments with me.    — kristynush (posted on May 22, 2003)

May 23, 2003
hi there, at the time of my open rny, i had bcbs il hmo, my experience was great! i was aproved to see the surgeon for consult and was aproved for the preop tests and i only waited 1 week for aproval for the rny, my medical group was fox valley medicine. i had my rny at delnor in geneva. i started at 5 ft 9 370 so my bmi was like 50 something if i remember correctly. i had been on several diets in the past involving doctors, dieticians and jenny craig and weight watchers but i never was made to verify any of it, the whole process was a very smooth and fast one and for that im very greatful! good luck to you! :) p.s, inowweigh 160 and still losing!!!!!!!!!!!!!!!!!!!!!! :)
   — carrie M.

May 25, 2003
Hi! I have BC/BC of Illinois, and they have been nothing but wonderful. I was approved less than a week after everything was submitted to them. I had a BMI of 52 pre-op and no co-morbs. I had my open RNY 1/2/03 and am down 90 pounds in less than 5 months! Good luck to you and God bless! :) ALLI
   — Allison B.

May 25, 2003
many people do not realize that alll bcbs policies are not the same. Your employer has contracted with bcbs to provide coverage and what and how much is covered will vary by employers. That said I have bcbs of Il thru the electricians union IBEW local 134. I simply called tham and asked them to check my particular coverage to see if gbs was a covered benefit. they did it while I waited, said yes it was if I was 100% over ideal weight for height. this was not an official approval, just confirming it is a covered benefit. the reviwed my paper work from my dr office and approved immediately.
   — **willow**

May 28, 2003
Hi, I live in Minnesota, but have BCBS PPO of Illinois. I called last year to see if WLS was covered by my in policy. They told me that as long as it was deemed medically necessary it would be covered just as any other surgery. So in Dec. My Surgeon's office sent a letter requesting approval. I was approved in less than 2 weeks. In March, my approval was recinded. An exclusion in the policy is what they said. After MANY phone calls and a LOT of STRESS, it was finally decided that it was medically necessary and that outweighed the exclusion in the policy. I did find that by working with ONE person in customer service instead of just who ever answered the phone, things went more smoothly. Find one person to deal with and insist on speaking only to them. They get to know you and your case and things go much better that way. AND last but not least, WRITE down everything. Names, dates, what was said.
   — Robin55449

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