What are my chances??

From your colective experiences, I'd like to get your opinion on what you think my chances are on getting help from BCBSAL.
I'm 5'5" aprox 225 41 years old
Mild to moderate sleep apnia
arthritis in my hip
very high cholesterol &
last but not least history of heart attack and stroke on my father's side (and they weren't obese)

I think a lot of it will be documentation.  You need to be sure that you have a recent 6 month or more physician supervised diet with at least once monthly weigh in.  A referral letter from your Primary care physician recommending Bariatric surgery is helpful.  All of your results with your co-morbidities documented.  I'm not sure that they will consider family history, unfortunately what they will look at is the cost effectiveness for them.  Seems that all insurances have really tightened up on this.  However, don't give up, fight for it.  This is a life altering surgery and it is well worth the fight.  Ask your Primary  care Physician to test your HgbA1c as well as your thyroid, these can be helpful!

GOOD LUCK and BLESSINGS!
Lisa

First and foremost you need to ensure your plan covers bariatric surgery.  Then read and follow their guidelines.  If you do not meet the requirements of your plan, chances are slim they will cover it.

There are options for self pay and making a loan as well.  If you've determined WLS is the only release from obesity, do everything humanly possible to get it!

Best to you.

just read this in my policey under excemptions: "This exclusion does not apply to surgery for morbid obesity if medically necessary and in compliance with guidelines of Blue Cross. Benefits will only be provided for one surgical procedure for obesity (morbid) per member under this plan"

It doesn't even mention the bmi or comorbidity.

I just don't see how I could possibly self pay.  I'd hate to see the loan officer when I told them what the loan was for.... no telling what the interest would be.

Call them.  They will refer you to a link that will spell out exactly what you need to qualify.  Follow it to the letter.....I did and had no issues getting approved....although my BMI was over 50.

Best to you on your journey!

Kim

Thanks.  I forgot to post the followup to my earlier post.
I emailed them after my earlier post and they replied and did exactly what you just said.  They directed me to a link that spelled it all out and from what I read, I qualify, at least enough, to make an appointment and get the ball rolling to meet all the requirements.
I forgot to post in the beginning that I also have had high blood pressure since my son was born in 2007. (I had congestive heart failure due to postpartum cardiomyopathy)
So, I have a bmi of at least 35 with high blood pressure. (i have sleep apnea but not to the degree to meet their criteria)

Keep us posted!  WLS was the best thing I ever did to finally beat obesity!!