BCBSIL: DS with BMI under 50

Has anyone been approved with BCBSIL for DS that has a BMI under 50?  It seems to me that their website specifies that the surgery is only covered with a BMI of 50 or more...  Am I reading that correctly?

Thanks in advance!

Get to know Diana Cox on the DS board. She is busy recovering from plastics, but she is responding to posts that are titled "insurance help," etc.  "Larra" can help, too.

BS/BS of Il just started covering the DS, so this is new. They are baby-stepping their way into the 21st century of bariatrics. You may have to appeal. The logic is that if the insurance company says you are fat enough to have a RNY, you are fat enough to have the DS. All of the research says the DS can be used on lightweights, as well. Especially if they have type 2 diabetes, chronic pain, etc. because those are contraindicated for the RNY. (RNYers are not supposed to take NSAIDS, and diabetes resolution is less "permanent" than with the DS.)

I had Aetna and went with Dr. Rabkin in San Fran. If you'd like to attend our Chicago info session/support group meeting, the next one is on November 16. PM me for more info. Even if you don;t use him as your surgeon, all are welcome.

For peer-reviewed medical journals articles and info you can use in an appeal, visit www.dsfacts.com.

Best of luck to you!

Nicolle

Hi,

I was approved with BCBSIL PPO, for DS. My BMI is 64, so they approved right away.

Yes you are reading that correctly with the BMI of 50 or more. I would fight it as well, if you rBMI is under.

Good luck with your process!