any approval problems with bcbs?

C3
on 6/21/07 1:40 pm - Detroit, MI
Hello, I'm new to this board, just wanted to know if anyone has had any problems getting approved with bcbs. I currently have bcn and they denied me because they wanted 12 mos. consec. weightloss history. I'm thinking about changing my insurance in December to bcbs because I heard that they'll approve the surgery with little to no problems is this true? I need to find out because my premium will be a lot higher once I change to bcbs but if it gets me the surgery I'll gladly pay it. Thanks
Brenda M.
on 6/21/07 2:31 pm - Westland, MI
I have BCBS PPO.  They required 12 months of weight loss attempts documented by by PCP.  It was fairly easy to get approved, compared to other insurance companies, but I still had to show the 12 months.

 

Ms_Jan
on 6/21/07 7:46 pm - Mid Michigan, MI

My BCBS requires the 12 month thing too. I think its almost a standard with them. Welcome to the board. Jan

229/125/125/115
starting/current/goal/new goal


Here's to a healthier new me!

lovinlifenow
on 6/21/07 7:53 pm - East Lansing, MI
i have bcbs ppo  and it was a smooth approval for me.  i think that since my bmi was so grand (grin) that they did not insist on the overt proof of the 12 mos.  I was approved almost immediately through my Dr.s office efforts.  You should check with your provider of the insurance regarding your specific policy coverage--because even though they are all called the same, they differ between employers.  good luck, rae
(deactivated member)
on 6/21/07 10:36 pm
I have BCBS PPO and I called them and they said for lap band they required a 12 consecutive month history too... my BMI is 49 so will see what my doctor can do for me... if worse comes to worse I will give them their 12 months and try to diet and make sure my doctor keeps records of it.   Good luck!
Magpie74
on 6/21/07 10:57 pm - NC
I'm LapBand, and I have BCBS MESSA... which was a total breeze.  There are different types of BCBS I guess???  I dunno.  I only needed a physician letter and that was it.  I sent my paperwork in 3/15/07 and had surgery 4/4/07.  So I guess it depends what type...
-Maggie- A "STUCK" episode is kinda like the big "O". If you have to ask, you probably didn't have one.
No dramaBanded 4/4/07 
322/209/170  - 113 lbs.
Start/Current/Goal
Pam T.
on 6/21/07 11:39 pm - Saginaw, MI
Just do the 12 months diet history. Will they approved you after you get the 12 months in?   It's really hard to deal with the mental aspect of starting another diet but it really does go by quickly.  I'm already past my 8th month mark and I'm surprised at how fast it went by.  And sometimes its just easier to comply with the insurance rules --- you can't really fight them. As long as you meet all the other requirements for BCN then you shouldn't have any problems. I personally wouldn't switch to another insurance company at the risk of having a waiting period or 'pre-existing condition' clause.  And most insurance companies have the diet documentation requirement anyway - some are 6 months, some are 12 months. I have BCBS and they require 12 months. Good luck Pam

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DeeM
on 6/22/07 12:14 am - Howell, MI
Hello,  I have BCBS PPO Community blue. I  had no problems with getting approved, didn't need the 12 months.........   but did need a physician letter. I also had Dr Wood as my surgeon, he is  a awesome doctor. Good luck to you. Any questions please email me. DeAnn
C3
on 6/22/07 2:45 am - Detroit, MI

Thank you all for responding I'm going to find out if there are different types of bcbs and what kind my employer offers and I also decided to start the 12 mo documentation with my physician. I really hope this works out for me keep you fingers crossed

CrystalH
on 6/22/07 7:52 am - Vassar, MI
I have BCBS but it is administered out of Virginia.....and i had no problem just had to have BMI over 40...
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