Blue Cross Blue Shield of Alabma

I live in KY and have BCBSAL insurance through my where my husband works.  In April 10, 2007 it was just released that they now cover for the lap band procedure. I am just beginning the process toward WLS and would like to avoid unnecessary delays. How has your experience been in dealing with them? Here is what I know: Regardless of the state of residence - Blue Cross Blue Shield of Alabama (PPO) has specific guidelines and criteria that must be met prior to approval for Gastric Bypass Surgery, listed below: 1. The patient must enroll in and complete a physician supervised weight loss program for a duration of six months in the immediate six months prior to request for approval. (Only 3%-5% of patients maintain non-surgical weight loss.) This actually requires SEVEN consecutive monthly visits. The diet should not be ADA (Diabetic) because that is considered treatment for Diabetes and not Morbid Obesity. Height, Weight and BMI should be documented each visit. 2. The patient's body mass index (BMI) must be at least 35 with significant co-morbidities or at least 40 without significant co-morbidities. 3. The patient must have suffered from morbid obesity for at least three years prior to request for approval. This must be proven via documentation over the past three years. 4. The patient must not have smoked within eight weeks prior to surgery. 5. Patients must also be at least 18 years of age. Thanks for any input! Angela

Hi angela, I'm from new hampshire so i dont know how much help I could be with this question except to let you know if you goto the menu on the left you can search insurance by state and find other people that have you're insurance, you'll want to search alabama even though you live in ky and just remember... everyones policy is different so you'll never know for sure untill you talk to you're dr or you're insurance company. Hope this was of some help goodluck

hi angela, I also have bcbs of al through my husband work (ADT).  I have been trying to get approved also.  So far I think all I have left to send them is the documentation of weight loss for 3 consecutive months.  on my plan, it is 6 months out of the last 2 yrs but only 3 months have to be consecutively. So confusing but what I was told is that in the last 2 yrs it could be i went 2 months and then skipped a month and then went back say to weigh****chers and then would count for 3 of 6 months. I have that documentation but dont have d3 months of consecutive diet so might have to do that with my family doctor.

I am waiting for approval from bcbs of alabama as well,I live in Louisiana. I have sent everything in, still no word. Anyone out ther been approved by them? If so, how long did it take you? I sent in 14years od dr. suppervised diet and all the regular stuff, BMI, etc. I thought it only took like 30 days, now I don't know.

 I have BCBS of AL but because my employer is a small business there are NO POLICIES available to our company that cover bariatric surgery.  And, no, I'm not simply going by what the people at work told me.  I was allowed to get involved with the process and try to get more information directly from Blue Cross Blue Shield of Alabama.  I was told point blank that there were no policies available to my employers small company that cover bariatric surgery.  It is excluded in all of the policies available to small businesses.  

Next, I tried to get individual insurance through BCBS of AL that I was willing to pay through the roof for... guess what?  None of the policies that can be purchased by individuals cover bariatric surgeries.

I'm posting this on this thread because while I sincerely wish you all the very best and I do hope that you get the surgery that may very well save your life... I want it known that BCBS of AL doesn't like handing out this surgery and they do all they can to avoid it.

Thanks for listening and good luck