PLEASE HELP BCBS NETWORK!!!

I have BCBS network and everyone I call tells me something different for the qualifications of WLS. I have spoken to my DR and informed her of my intentions and she is going to help, but I have to jump through all of her hoops first, then all of my insurance co hoops this could take another year or two. I am hoping there is someone that has my same insurance and can lend some advise. This is my very first post, and I love reading all of the support that everyone has for each other it is so encouraging. FYI--I am 5'5 284lb BMI 47+ every year I just keep getting bigger and bigger. I have GERD, my joints are starting to weaken, depression, and my father died at 34yrs of age from heart disease (he was not over weight though). Please help me I am so depressed and at the end of my rope with this whole weight issue....sick of being sick and tired all of the time!!!!!

Hello Katrina, Welcome to the Michigan Board .Can I first ask what kind of BCBS dO you have ?? I've got Bcbs -ppo which asked for any kind of diets I've tried over my life spand . I replied which once haven't I been on which I'm sure is true for most people who are on the board!! I'm 5'1 1/2 start off weight of 298 & bmi of 56 . I know just how you feel . But what kinds of things are they asking you to do ???? Sometimes there is just know way around jumping through hoops I hate to say if you don't have records of weight loss .But let me tell you what really helped me was having sleep test done .They found out that I had it and thats really helped push things through as I didn't have heart trouble or any of the major things that come from being over weight ...I was just very depressed fat girl .hang in there ! God Bless sue

I have BCBS PPO. I was 22 when I started the process so my requirements were a little different then let's say my mom (who also had the surgery) because of my age. I had to provide them with at least 2 (they asked for 2, I gave them 10) years of doctor documented dieting attempts. I also had to send them records of my health problems and how they directly were weight related. (the bad back, the bad knees, the asthma, etc.) They then required me to be cleared by a thearipist and go through a bunch of breathing tests because of the asthma. I did not have to have the sleep apnea test nor did I have to go through a cardiac work-up (my mom was required to have the cardiac work-up and stress test). It took me about a month to be pre-approved. I also wrote BCBS a letter explaining to them how my daily life was and how I would be dead at a very young age if I didn't have the surgery, etc. So I don't know if that helped, but I am sure it didn't hurt. Don't give up if they deny you the first time. Keep bothering them and make them listen to you. Good luck Julie

I have BCBS through the city and mine was a breeze. I gave them a letter from my PCP, Rheumatologist and a list of all the diets I'd been on since I was 15 years old. Those along with my BMI were all I needed.

Are you meaning you have blue care network? Do you have any diet documentation from your doctor? With any insurance you have to find out their requirements for surgery. Call them and ask them to send the requirements to you, that way you have a straight answer. If you have blue care network, you could call and ask to speak to your case manager, who is supposed to help you with any health needs and set everything up for you,. I hope this helps Hugs Linda

Hi there, I may be able to help you. I work for an insurance agency and we represent many carriers including BCBSM and BCN. Please e-mail me at [email protected] Thank you.