Blue Cross & Blue Shield of IL
I have Federal BCBS, which I've figured out falls under the states' BCBS rules...
I had my surgery in Virginia, so I think the guidelines were different - BUT, BCBS no longer "preapproves" surgery. Its up to the Dr after you have the surgery to convince them that it was medically necessary and you met all the guidelines. When I had my surgery (almost 2 years ago) Virginia's rules were to have 1 comorbidity. My BMI was not quite 40...
Its kinda scary when you think of it that way... as it could not be approved and you may be footing the bill.... I had it explained that way to me for my tummy tuck too... same rules... it was not approved the first 2 times and was finally approved the 3rd time...
Good luck with your surgery!
I had my surgery in Virginia, so I think the guidelines were different - BUT, BCBS no longer "preapproves" surgery. Its up to the Dr after you have the surgery to convince them that it was medically necessary and you met all the guidelines. When I had my surgery (almost 2 years ago) Virginia's rules were to have 1 comorbidity. My BMI was not quite 40...
Its kinda scary when you think of it that way... as it could not be approved and you may be footing the bill.... I had it explained that way to me for my tummy tuck too... same rules... it was not approved the first 2 times and was finally approved the 3rd time...
Good luck with your surgery!
HW-218/SW-208/CW-126/ Lowest Weight-121/Goal-125 - hit 8/23/09/Height-5'3"
Regain 30 lbs from 2012 to 2016 - got back on track and lost it. Took 8 months.
90+/- pounds lost BMI - 24 or so
Starting BMI between 35 and 40ish?
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