1.  Where do I start? (How do I go about getting this process started?) BCBS AL requires the patient to have a 6 month supervised diet and must run consecutive months with no lapse in months so I would first start seeing your personal physician and start the 6 month supervised diet is the first place to start
2.  BMI has fallen (in the past) under 35 but not for long, is this a problem? The process will start with your begining weight at the time you start 6 month supervised diet, yes if you fall below BMI 35 it may be a problem.  However you mentions high blood pressure and that could be considered as a co-morbidity  
3.  I would like to have another child, not in the immediate future (maybe another 2 to 3 years).  Would this be a problem? After weight loss surgery that a individual can become pregnant a couple years down the road should not hinder.  I

If you have further questions do not hesitate to contact me via PM

FEP will go by your begining weight as the BMI when you orginally see the surgeon, that is how most surgeons office send in for pre determination and authorization  I have also included the FEP 2011 guidelines for WLS

FEP 2011 Definition of Morbid Obesity:
A condition in which an individual has a Body Mass Index (BMI) of 40 or more, or an individual with a BMI of 35 or more with co-morbidities who has failed conservative treatment; eligible members must be age 18 or over.

Benefits for the surgical treatment of morbid obesity, performed on an inpatient or outpatient basis, are subject to the following pre-surgical requirements.
The following requirements apply to gastric restrictive procedures, gastric malabsorptive procedures, and combination restrictive and malabsorptive procedures to treat morbid obesity:

• Diagnosis of morbid obesity for a period of 2 years prior to surgery.
• Participation in a medically supervised weight loss program, including nutritional counseling, for at least 3 months prior to the date of surgery.
• Pre-operative nutritional assessment and nutritional counseling about pre- and post-operative nutrition, eating, and exercise.
• Evidence that attempts at weight loss in the 1 year period prior to surgery have been ineffective.
• Psychological assessment of the member's ability to understand and adhere to the pre- and post-operative program, performed by a psychiatrist, clinical psychologist, psychiatric social worker, or psychiatric nurse.
• Patient has not smoked in the 6 months prior to surgery.
• Patient has not been treated for substance abuse for 1 year prior to surgery.

to my understanding because i lost xxx amount of weight and have an apron i could have a panni. to help get my body back to being "normal" and not disfigured. is this not the case?  im not really wanting anything "added" just the skin i cant tone removed.

Hi,

My BMI is about 40-41 today, which was my first supervised weight loss app't.  I had met with surgeon last year (then thought I could do it on my own), my BMI was 41 then.  He told me then I needed to lose 15# before surgery.  My understanding is my doctor's office turns in first weight, then we are to be on the liver reduction diet until surgery (whole 3 months).  I asked the coordinator about losing weight and if that would effect my coverage if I go under 40 BMI, and she just said to talk with doctor at my next visit (2/28).  I don't want to mess up, I am not supposed to gain either.  

I would not worry about it, but I just barely made the required bmi (I have no comobidities).  I am going to talk with doctor's office tomorrow to make sure I am doing what I am supposed to do. They do not put in for approval  until I have completed the 3 months and like I said before I am supposed to be on liver reduction diet right up until surgery.

Thanks for your help!

I didn't even know there was more than one type until I started this process. I have the basic BIC card (white w blue writing) if that helps at all. You know I wanted the band, got scheduled mistakenly for the bypass, and ended up prefering the sleeve lol I live in Red Bluff (north of Chico) and just went to my county office and applied so whatever Medi-cal that gets me.