please help if you can

I have gone through all the steps to have wls (Dr. Daniel Smith - Park Rapids,MN), but was turned down by my insurance.  (Blue cross, Bue shield of North Dakota).  this took place in April.  at that point i became discouraged and put it aside.  I am ready to proceed again and wondering if anyone can give me any info on how to go forward.  i really do not have a pcp, but have seen Heidi Olson Fitzgerald(PA at Innovis, Fargo), so did schedule an appt with her on june 12th.  i am just under the 40 bmi mark and have been between 35 and 40 for the past three years.  and even though i have high cholesterol, i have chosen not to go on medication yet.  (trying to bring it down with diet, exercise etc)  but since that is not working, I am going to ask Heidi for medication for high cholesterol.  will that help?  anything else you can think of would be greatly appreciated!  thank you.  Dyanna

What insurance are you currently under, the BCBS of ND? Do you know what their guidelines are for covering weight loss sugery and do you meet them?

That's how I started my process.. I made sure I met their guidelines for coverage and then persued it through my WLS office. I have Health Partners and I had to provide documentation of 2+ years of being over 40 BMI.. so if you don't have a physical history to submit from a doctor documenting your history of BMI then thats where you could run into a problem.

Good luck!

You really need to advocate for yourself.  Like Stacy, I have HP too and did not have a bmi over 40 for 2 consecutive years.  I had letters from my PCP as well as supporting documentation from my psychs.  I also wrote a very personal letter on my behalf letting them know how my weight affects my daily life.  As an insurance company, they should be on board with you trying to be proactive in improving your health...let them know that!!!  Be aggressive...APPEAL YOUR DENIALS!!!

Best of luck!

Call customer service and ask for an appeal, submit any documentation you have that might help you out. I tell people to think of an appeal as your showing your evidence to the jury in court, make them want to rule in your favor! 

I had BCBS of MN at the time of my surgery. They want a BMI over 40 for RNY. Is that the surgery you're going for?

Any co-morbidities that you can document, do so! If it's high cholesterol, take action & get on some meds. Have you been tested for sleep apnea yet? That's a big one most aren't diagnosed with, but it's worth the sleep study IMO! High blood pressure? PCOS? Diabetes?

I'll PM ya a couple other thoughts on this.

Keep moving in the right direction, if it feels right - it is! BCBS can be won over!!!