Question:
How hard is it to be approved?
I'm new at this, I have a Dr.'s appt Oct 23rd to visit my PCp for the first time. I have only been to my obyn in the past years only for my pregancy. I'm 5'0 240lbs twenty eight yearold. My BMI is 46.9 and I'm very worried about my weight. I have tried all the diets, akins, low calaroie, high protein, starving myself. Nothing works I was on fin fin years ago lost alot of my weight. Stop and guess what gained it all back. My legs are starting to go numb when I lay down, I'm out of breath, back hurts, etc. I'm sure you all know the symptons. I never new my insurance would possibly cover this surgery until recently. BCBSOFGA-PPO. I have a seminar scedule for OCt30. I'm looking at Dr. Duncan in Atlanta. Basicly, I dont really know evry step there is, I have to take. Any advice would be great. This is something I have researched with my husband, and something I now know I want to do, so I can live a healthier life, with my two boys. Please help? Thank you so much — Michelle J. (posted on October 14, 2003)
October 14, 2003
You need to start getting a diet history together in documentation form.
Most insurance companies require it. Some companies require physician
supervised dieting of a specific length within the last year. If I were
you, I'd call your insurance company and get in writing their specific
requirements, so you can make sure you can satisfy their requirements. If
you don't have a recent physician supervised diet and you find out your
insurance company requires it, get started now as most won't budge an inch
on that requirement.
— Cathy S.
October 14, 2003
I have BCBS of IL PPO. And I have been waiting to get approved since the
end of August. I call them everyday and one of the customer service reps
told me she has been seeing letters going out that they are requiring a
12-18 month diet before approving the surgery. A lot of insurance
companies are requiring at least a 6 month doctor supervised diet. If I
were you I would go to your PCP and get started on a diet now...at least
have your PCP document you were there to begin one, and go back once a
month to get weighed. Blue Cross is getting very strict about approving
this surgery.
— Kara J.
October 14, 2003
Michelle, click on "My Journey" at the top of the page and follow
the path. This is what I did and I was very succesful. Not everyone gets
approved the first time or as fast as I did, but the step by step process
that the AMOS pages take you through are very good to follow. Best wishes-
— M B.
October 14, 2003
I haven't been aproved yet, but have learned a lot from ALL of my friends
here. Get letters from as many Drs as you can saying you need WLS. Do you
see a Chiropractor, Allergy Dr, or any other Dr that can give you a letter?
Definitely get back with OBGYN Dr. He can write a letter saying that you
need to have this surgery for health reasons. Also, I agree with a prev
person that said you need to make a DIET HISTORY. Sharon Brittain on this
site has a wonderful letter that she doesn't mind sharing (for you to write
your own letter stating why you need to have this surgery. You can also
make up a FAMILY HISTORY and a LIST OF CO_MORBS that you have that will
help you get approved too. Like I said, S Brittain's site can help you with
all of the things I've mentioned here. She has been of tremendous help to
me and 100's of others. Best of Luck on getting approved!! Oh, one more
thing. I would get on the internet and pull up a copy of the policy
guidelines regarding WLS on you specific insurance. This will tell you
EXACTLY what you need to do to get approved, if this is a covered service
under your plan, (at least mine did)!!!
— bufordslipstick
October 15, 2003
Hi! I have BC/BS CareFirst. My paperwork was just submitted on Thursday
and I received a call Monday morning saying that I was approved. I wrote
my own letter and made a Diet History chart and had my surgeons office turn
them in with all the other paperwork. My advice would be to put together
as much information as possible. I was able to get documentation from a
couple of weight loss centers that I had gone to in the past (Jenny Craig
& LA Weight Loss) as well as a couple of diets I had done through my
Doctor. If you have anything like that I'm sure it would help. Good luck
to you!!
— Michelle E.
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