Anyone with BCBSIL PPO?

Hello, I know all BCBSIL PPO contracts are different with different requirements. Does anyone with this insurance have to lose a certain amount of weight? Does it state this in the insurance requirements? Thanks Much!                         Renee

I never saw anything like this as part of the insurance policy.  I have heard that some doctor's require that you lose weight before they will do the surgery, but that has nothing to do with the insurance.

I have BCBSIL PPO .. and there was NO weight loss requirement

No weight loss requirements. Actually I did not lose any weight for the first 3 months of the diet

I would talk to your surgeon's insurance coordinator about his/her experience with that. When I thought I was still getting the RNY (instead of the DS) several months ago, the insurance coordinator at Northwestern's Wellness Institute (pipeline to NW's bariatric program and Dr. Nagle) told me that I should lose some weight for BC/BS of IL, as they were tightening up their "unofficial" requirements for the 6-month diet. She recently had some patients denied over this and Wellness Institute's PCP, Dr. Julie Roth, needed to go to bat for them to get their approval. Even 10-20 pounds, she said. She said BC/BS thought that if the patient couldn't lose even a little weight with a doctor's help then maybe they weren't going to be successful with a RNY, since closely monitoring food intake was essential to success with it. That's all I know. Good luck! Nicolle

I have BCBS/IO and I had to lose 25 pounds to get approved. My BMI wa sover 50 and it had to be under 50 to get approved. I was approved for RNY with out weight loss but I wanted the lapband. So I had to do what was needed. I started last November just before Thanksgiving lost the weight in ...2 1/2 weeks. Got approved and a date set for Dec. 27th. Had my gallbladder removed instead. So yes your insurance may ask for some weight loss first.   Karen

Would that not have to be under their requirements then?

I believe so. After I followed their requirements all went very easily.

         Hi Renee I have BCBSIL and I have not seen anything in the policy that states that you have to loose. Your Doctor may require you to loose weight prior to surgery to shrink your liver or something. My Doctor is Dr. Cahill and he told me because my BMI is under 40 so who know's. I would call them and ask them what is going on and what the requirement's if any are there. Keep me updated. Hope to hear from you soon.

Hello, I previous worked for Blue Cross.  You don't have to lose any weight.  In regard to weight issues the only requirement is that your doctor states in your medical records that you are on a reduced calorie diet, usually 1200 to 1500 is acceptable.  But it really depends on what your doctor feels is sufficient.  Now your surgeon may require you to lose a quick loss right before surgery to shrink your liver, but that is something different entirely.

Janet