bcbs of il ?

Hi from Indiana everyone. Hope you dont mind me asking a question here. I was wondering if bcbc of il is really picky about their 6 month diet. Do they expect you to lose weight or just try. Im not having much luck im on month 2 and only lost 6 lbs so far. Please anything you can tell me about them would be a HUGH help. Thanks for your time. 

Just my opinion here but I believe that the underlying reason for the supervised diet is their hope that you will give up and just go away.  Then they won't have to pay for the cost of the surgery. Whether you lose or not is not what they are looking for. Just that you go month after month and have the doctor document what you have tried.  Make sure they send you the outline of what is needed so you will be sure they don't get you on the tiny details that may be left out by your doctor. The main thing really is that traditional diets don't work so we need to have WLS surgery. Good luck.

yes that does make sense  doesnt it. Thank you for the reply Ronna, sure makes me feel somewhat better.

Hi, I also have BCBSIL and I lost 5 pounds by the end. I was denied and the explanation was that I did not have a 6 month VERY low calorie diet DR supervised diet as evidenced by lack of substantial weight loss. Watch out I was on a very low calorie Dr supervised diet. Not sure but the lady who deals with appeals said I had everything and they were just nit picking. It has been 9 months now, and with a knee surgery and not being able to exercise much my weight has gone up a little and down. Haven't heard anythign from appeals yet.            Renee

wow thats messed up. I sure hope your appeal has better news. I've heard they pretty much always deny the first time for any reason. They need to realize like Ronna said if we could lose it on our own we wouldnt need them. good luck on getting your approval  Renee.

Dear Renee: 9 months is WAY to long not to have heard back on an appeal.  Are you sure one was filed?  Just talkiing to someone at BCBS is not the same as filing an appeal.  It has to be done in writing.  Please call them right away and make sure that they have an appeal on file for you.  They have to respond to an appeal within 30 days from the date that they receive it. BCBS of IL has the reputation of denying the first request just to see if you will go away.  Once shown the error of their ways, and if you have met ALL their criteria, they will approve.  They just like to scare people away. Good Luck and let us know how it goes,

Feel free to read my profile regarding BCBS. I had MAJOR trouble with them. I had to do a year supervised diet (I started the process several years ago) and was denied saying I did not lose enough weight. I started ALL over and did it again - following all thier rules to the letter. I then got denied saying I lost TOO much weight and therefore could do it on my own. I appealed and appealed with no luck. I finally switched insurance companies and got approved within a month. Good luck with them - be sure to give them everything they require and do not give up the fight!

Hi Melissa! Yes, they are really picky about the 6 month diet.  Just that you DO it, not necessarily that you lose weight on it.  Besides......you HAVE lost weight!  Way to Go!!!!! You must see your doctor once a month, every month (no less than 21 days apart and no more than 35, I think) and you must discuss what you are doing, eating, exercise, and what your goals are.  The diet is to show that you can and will comply with the drastic lifestyle changes that are necessary after surgery. I made up a form that I took with me each month to be included in my file to make sure that the doctor did not miss some nit-picky thing that they might be looking for, but many surgeons now have a form that you can take with you. Good luck and if I can help in any other way, please let me know!

Thanks so much you all this is such a big help. Had my 2nd app today and just lost a pound, which is better than nothing I suppose. Good luck to everyone.  ((((HUGS))))

Hiya, yes the appeal was filed but its only been with BCBSIL for 2 weeks now. I was told to just keep going for the weigh ins. I hope they like denying  me the first time. Since I haven't been able to lose anything it did not help my knees and so far they ended up paying for one knee surgery with the second to follow. I guess they would rather pay for these kind of things than to help us live a healthier life. I have a weigh in Thursday unless anyone else here comes down with hubbies flu virus. So we shall see I can ask the girl at the office then. I would hate to work for the insurance company. I could never turn people away that truly need help. Good Luck to everyone out there on approvals.                          Renee