Newbie- BCBS State Health Plan

Hi everyone!
Well, I've been trolling through these boards trying to find out as much info as I can. I called my insurance provider (BCBS State Health Plan) and got the requirements for lap band surgery.
They require 5 years of weight loss attempt documentation. Has anyone done this? How strict is it? What exactly are they looking for?

I am scheduled to go to the required informational meeting on Jan. 12 in Durham to start the first part of the process. I'm nervous, a little scared. Any info. you can give me would be great!

Thanks for your support!

Hey there!! Good Luck with your pre-surgery requirements. I'm not much help as I had different surgery and a different insurance. You may want to try posting on the Lap Band forum and the insurance forums. Hope you get the answers that you're looking for.

- Iris

If you are going to Duke they will be able to let you know what the BCBS state plan requires because they deal with on a regular basis. Ask plenty of questions when you go. 

You can also go to their support group meetings even before you have surgery. It's a great way to meet people undergoing the process and to ask questions of the staff. I attend their meetings on a fairly regular basis. 

Wising you all the best,

I had RNY in 2007.  I'm also a state employee.  The plan does require documentation of the 5 years.  I had my weigh****chers booklet with weigh-ins documented for a few years.  I also just wrote up the different diet "plans" I had tried over that last 5 years, like Atkins, South Beach, etc.  They took it and I was approved in less than 3 days.  No problems.

Good luck!

Alice

Thanks everyone! You have been a big help so far. I have also done ww in the past, but no longer have my booklets. Now I wish I would have saved them! I hope to find out more info. at the meeting on the 12th. Thanks for the tip about the support groups!

I have the state helth plan and it was easy.  I got a print out from my family doctor of my weight history and my doctor's office took care of the rest.  They submitted the package on Monday and I was appoved when I called BCBS on Wednesday evening.

Good luck to you.
Kelly

Ya...it's simple. Just get one documentation of your weight for the past 5 yrs. Your surgeons office pretty much takes care of everything. Good luck to you!

I got medical records from my physician for the past 5 years. I went thru the record and found where when I went in he had documented that I was doing weigh****chers, HMR program, atkins, etc.

I would start with dr. records and see what they have. Blue Cross wants you to have a BMI of 40 or above.  See what records say

Tamara

Thanks so much! I actually have a BMI of 52 (sadly) with high blood pressure that is currently controlled with an ever increasing dosage of anti-anxiety medication (I think it controls is temporarily, then it eventually goes up because it's really caused by my weight).

The only problem I'm thinking of is that I graduated from college in May of 08, and for the previous three years I was seen intermittantly when I had an ear infection or whatever, at the local ER. I can call and get those records, and I have ones from the years before that where I was overweight, and obviously consistently for the last year and a half. Do you think those will be adequate?

My mom, who had GP several years ago, suggested I get a letter from my regular doctor, too. What do you think?