BLUE CROSS BLUE SHIELD TN UGH!!!

2Weimowner
on 2/25/14 11:49 pm - Spring Hill, TN

I am just starting this journey and have discovered that with my insurance - BC BS TN they require for the individual to lose at least 10% of their body weight.  In my case 23lbs.  I currently weigh 234lbs.  I have metabolic syndrome (prediabetes), hyperlipidemia, high blood pressure, hypothyroidism and super ventricular tachycardia.  I am on several medications and know that this surgery could change my life.  I am seeking to have the surgery so that I can get off several of these meds (metformin, gemfibrozil and Victoza).  I WISH I could lose the weight but I fight against the hypothyroidism.  Can anyone tell me if your insurance is BC BS TN and does the subscriber number start with CHH?  If so, did BC BS approve you for the surgery even if you didn't lose the 10%?  I'm so frustrated right now.

Hislady
on 2/26/14 2:59 am - Vancouver, WA

The only way to find out for sure is to contact the insurance company because each policy is different. They will have all the info you need and if there is a way to work with in the requirements. Usually they go by BMI and co-morbidities, haven't heard of a percentage requirement myself. Good luck!

jasoncline82
on 3/24/14 11:47 am

I have BCBS of TN as will and I started my weight loss journey at 308lb and am not at 281lb i still have to loose 4 more ib before they will approve me.  Everything i see from them require this .  i also have many medical issues Fatty Live, Hemocromotosis, lipid issues, low Testosterone, knee issues etc.  They have required me to lose the 10 precent. And i do have a number starting with CHH.  Wish you luck with you journey.

Cicerogirl, The PhD
Version

on 3/24/14 1:35 pm - OH

If you are taking medication for the hypothyroidism and your lab levels (TSH, T3, T4) are in normal range then you aren't "fighting" your thyroid to lose weight.  Many of us are hypothyroid (but have normal levels when on Synthroid or whatever) and at some point used it as an excuse for gaining or not being able to lose weight, but it really isn't a factor.  With all the other issues you have, there might be things that contribute to the weight, but it isn't just a thyroid issue.  

You are still going to have your thyroid issue even after you have surgery (but, as I said, it really shouldn't be a factor), and much of this process is mental rather than physical.  I truly don't say this to be mean, but one of the first steps to being able to be successful (even with surgery) at getting the weight off and keeping it off is to accept that we are obese because of what we eat and that we CAN control our weight by controlling what foods and portion sizes we choose.  We have ALL made excuses for our weight, so I am definitely not judging you.  I just really want you to be able to let go of the excuses and replace them with an "I can do this" approach.

If one of the written requirements is to lose the 10% of your weight, then they are likely to deny approval until you have done so.  If you have not already seen the written policy on bariatric surgery, get a copy so you will know for sure. (It is likely online.)

Lora 

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

Most Active
×