BCBS of Illinois

Hey folks, Anyone recently had any experience with Blue Cross Blue Shield of IL? They have recently changed their policy on WLS. According to the folks there, they now require 1 YEAR of medically supervised weight loss before they approve WLS. Has anyone had any success negoitiating this? If I have to start a one-year process here, I will be quite upset. It's as if I have to start a one year process intending to fail! If I suceed with my medically supervised program, well, I don't qualify. I also will likely gain it back based on my past history. If I fail, they probably say I am not a good candidate for WLS since I cannot stick to a diet. Gee, could they be trying to get out of paying altogehter? Nah, that would never happen, right?

Sorry Mitch, but I've never heard of anyone negotiating such a thing with an insurance company. I am so very very thankful that my surgery was in 2003, before BCBSIL got so nutty.

Hi Mitch, I have just completed month 9 of the 12 mo diet. I don't think this is too new but when I started originally, it was 6 months long. I got nervous when I began reading your post, because the rumor was that they weren't going to cover it at all in 2005 and I thought that's what you were going to say. So far I haven't heard anything on that so keep your fingers crossed. I have to have a 12 mo supervised diet(amounts to a monthy weigh in-hope that will be good enough) AND a twelve month dietician program which recently had to be increased from 6 to 12 months. I am in hte Riverside Program in Kankakee. If they don't elimiate or change the program I should be good to go anytime after March when I complete these programs.They say BCBS WILL NOT BUDGE on the 12 mo. aspect. I started off losing, but it's just been to hard to keep up the momentum once they extended it to 12 months. Good luck to you. Sherry

they are correct in some ways.....one year from today is 2006 no wls in 2005

I hope we don't have to start the process over once we decide to try and qualify for WLS. I've been going to my PCP for the past 10 years for high blood pressure and weight control. He has had me on Merida, I've been to see the dietician more times than I can remember and I even took a weight loss class the clinic offered. I sure hope all of this counts toward the requirements. Ed

Yea, I know what you mean. Let's be real here. Is there anyone looking for WLS who has not been to the doctor and be told to lose weight? Is there anyone who has not seen the dietician, etc. In my case, I had the wonderful opportunity of having a heart attack in January 2003. Since then, I have been in an ongoing cardiac re-hab program where weight control is part of it. I am hoping they will consider that to be doctor supervised. If not, well, who knows.

Mitch from past posts they wont budge.... on their policy.... IF you have a good family doctor start one with him sometimes they let you just come in weigh and leave without any real "supervision"

Hey Mitch! I'm going through the same thing w/ BCBS IL. I have 8 months down and 4 to go... my consultation was scheduled for 1/19, but I decided to do some last minute checking to make sure my policy hadn't changed with the coming of the new year... and they gave me the news of the 12 months supervised diet! I already have 8 months documented and I'm currently still on a weightloss program so hopefully this next 4 months won't drag on like I think they will... I called my surgeon's office and they advised me to reschedule my appt. They said that the ins company would love for me to submit for approval now so they can deny me and keep me wrapped up in appeals. They said that it would go alot smoother and maybe even faster if I wait until my 12 months is up. Good luck to you.