NC State Employee's Health Plan

I have a dear friend who is planning to have WLS. I wanted to get some feedback on what the State plan requires to approve the gastric bypass surgery. She works for a University. Any information would be great as she starts pulling her packet together.
Thanks!

Hi there. The state health plan is BCBS. They require a BMI of 35 and one co-morbitity (hypertension, diabetes etc) or a BMI of 40 or more. From what I understand, if she goes to a center designated as a Center of Excellence, they'll accept her if the center feels she is a candidate. Duke is a Center of Excellence.
Good Luck to her!
Vini

I had my surgery 19 months ago using the State Employees Health Plan.  They require a weight history of 5 years--primary physician was able to provide this and they had 5 different consults that they required.  A Bariatric CEnter of Excellence will help direct the patient through these consults.  If this surgery is a consideration I would advise pursuing it ASAP as the State Health Plan guidelines may change due to the economic situation.  Our plan is up for renewal by  July 1.  The customer service folks were very helpful in answering all my questions.  I was approved 3 days after they received all of my info by fax from my surgeon.  I had my surgery at Nash General Hospital in Rocky Mount and was well pleased with my care. 

I had my RNY in Oct 07.  I was approved in 3 days.  They are very pro WLS from my experience as long as all their criteria is met.  Tell your friend Best Wishes!

Here is a link to the BCBS website for what they require.  This is what I read over before meeting with my PCP to discuss the surgery.  He thoroughly went over my medical records to document on my application the other health problems I had due to my weight.  I also made sure I chose a BCBS Center of Excellence that has a lot of experience with the state health plan.  Hope this helps.

https://www.bcbsnc.com/assets/services/public/pdfs/medicalpo licy/surgery_for_morbid_obesity.pdf

Thanks guys for the info! I told her I thought she woudlnt have any problems as compared to other health plans.

I did mine through State Employees BCBS and had no problems.  I apparently qualified and met their criteria with little or no effort.  My surgeon sent me to the hospital lab to get my labs done.  He sent me for a psych consult, a nutritionist consult, and I had some basic physical exams and tests run.  That was it.  I think all those a standard, based on what I hear from others on OH.