Calling all sleevers with BCBS of Michigan

Sorry to do this again, but I really need some feedback....

Please PM me or reply if you have had the VSG and BCBSM PPO and insurance paid for it with a BMI under 50....

Still having major issues with insurance telling me one thing, surgeon's office is getting other info, etc.... 

If you have anything you can send me, approvals, appeals, etc I would greatly appreciate it...

It has to be  a BMI of under 50, mine is around 40...  because they do cover it if you have a BMI of 50 or over, but I don't... 

Thank you soooo much!!!!
Candy!

WIsh I could help you.  I have BCBSM PPO, but my BMI was over 50 to start.  Once I met the 6 month criteria for "dieting", the dr's office secured approval with no difficulties for my VSG.

You're in my thoughts as you continue to pursue this.  Keep trying and continue calling the insurance co.

Joyce

hey Candy, just hang in there!!

im afraid i cant help either... my BMI was 85 when i started, so after BCBS changed the requirements for surgery, i was automatically approved....

i hope you find the info your lookin for... just call your doc's office everyday if you need to find the answer... and dont give up...

we'll keep ya in our thoughts that you will make it to your surgery!!

~jenny~

I have even read that BCBS-MI has automatically approved the VSG with BMI's over 52 without even the diet history. But I don't know how accurate this is. I just hope it is accurate for my sake.

It sucks a bit to know that if you GAINED weight you could get approved easier. How screwed up is that!

I agree with you.  I went on Atkins and lost wieght and thought it would be a better situation for sugery.  Nope, they wouldn't consider it until my BMI was back over 40.  Go figure.

I have BCBSM PPO thru the State of Michigan.  Am a retired employee.  My BMI was 44 and got the VSG approved but I had to get an exception.  The insurance required a BMI of over 50 and approves VSG as a first step toward the DS.  In my case I could not have the RNY or DS because of previous resections of the small intestines and colon.  I thought the only options was the lapband but I really didnt want that.  After talking with the surgeon he agreed that the VSG was my best bet and he put in for the exception.  It took six weeks but was approved. 
Good luck
Dana