any approval problems with bcbs?

I have bcn .   It took  a year to get approval because my pcp didn't document any of my weight loss attempts.   I was approved through an in person appeal .    The up side is, they paid ever penny of it, all i paid was 60 bucks for the psyche exam, and he actually mailed me back my check.    With surgery and complications, it cost them over 300 grand.    I also had a second insurance, but they wasn't billed for any of it.    As for changing to blue cross, find out and make sure the plan will cover wls.    Some employers exclude it.    If it were me, i wouldn't wait til december to change and then see.....start your diet now and make sure you do everything bcn tells you, after that i don't think they will deny you. Good luck in your journey Linda

I had BCBS but of Delaware (live in Michigan, but that's what my employer offers) PPO ... they approved with no 12-month history of dieting; or maybe my doctor's office just knew how to present it to the insurance company (although they dragged their feet getting it to BCBS and slowed down my surgery ... but oh well, I had it done). The only thing my insurer wanted was a cardiac consult and stress test. Otherwise, I was approved with no problems. But it depends on what your employer provides through the insurer ... they are all different. You have to check your policy. Good luck.

It is my understanding that Blue Cross/Blue Shield of Michigan requires the 12 month diet history for all of their various programs and policies -- I went to a weight loss surgery seminar at Henry Ford Hospital, and the nurse who is the program administrator said this was pretty absolute.  However, what it boils down to is what your doctor counts as a medically supervised weight loss program -- there is a lot of variation here, some are content with weighing you two or three times a year, asking you if you diet or exercise, and then advising that you lose weight, which can be as casual as saying "I think you should eat less and exercise."  So, if your doctor is willing to STATE to blue cross that they've supervised you for a year, you'll be approved. If your doctor can't or won't state this in a letter for you, your only real option is to institute a more formal plan with the doctor -- at the Ford thing, they suggested monthly or bi-monthly checkups along with a formal diet plan and exercise plan which allows the physician to document your efforts in writing.  Also, another thing you could do as a backup is to go to weigh****chers simultaneously for the one year period, so that you have both to rely on. I hope this helps you.  It seems so unfair that the insurance companies can be so unwilling to help pay for the things that PREVENT problems, but will pay for the treatment later -- just stupid.  If it were up to me, I would require insurers to pay for anything which could be viewed as preventatitve, from yearly physicals to weight loss surgery.