Gathering info-help please

Has any one gotten Horizon BCBS NJ to approve vertical sleeve in a patient that has a BMI of 35...and has a couple of comorbidities.
or know how to get the info on the BCBS site..I cant find any thing on that site

Thanks for the help

I *think* you need a BMI over 50 for most insurances. I am in NJ and have Amerihealth PPo which is an awesome insurance but I still need the BMI and comorbidities factor to get approval.

Kelly

 yikes I would not have been even close if my insurance needed my BMI that high.. 

Noooooo! I know peeps that had BCBS (not in Jersey), and got approved without a BMI of 50!

Most insurance it's a BMI of 40+ OR BMI of 35+ and a comorbidity or two. Call your insurance company and ASK. Even if they tell you they don't do the VSG, ask about RNY requirements. You can always try switching to the VSG when you visit the surgeon. Don't give up!!

I LOVE your avatar!
Jeni

 I know the way my insurance was it was BMI of 35+ comorbidities or BMI 40+ l had no comorbidities but I had a BMI of 41.9 so I had just barely made it lol.. all you have to do is call and ask..