Is this a lost cause??
Okay ..here it goes. I have checked with BCBS IL with all of their rules and regulations in regards to the weight loss surgery. I am aware of the co morbidities (which I have a lot of them) However, one of their stipulations is that I need to have 5 years of documented proof. Well, I think I may be able to dig some up..but I did not go to a doctor on a regular basis until the end of 2005. In 2004 my back gave out and I went to a doctor in the previous town I used to live in. That was only once in the year. 2005 I want to a doctor which is a general doctor, however I rarely see him. The people that handle my main problems are my neurologist and my gyno. Since they are the ones handling all of my problems, I saw no need to go to the regular doctor. The only thing he would ever say is "That is something you should ask your gyno/neurologist"
I just know that I am a good candiate for it b/c I have a BMI of 50, and have a lot of co morbidities. My only fear is them pretty much knowing that I may drop dead at any time but not caring just b/c I have only had 2.5 years of the documented weight loss.
I know insurance companies are sticklers- my mom fought for 4 years with hers before she got approved. Has anyone had any experience with thier insurance company where they have been denied and appealed and found a light at the end of the tunnel (even though you may have not had EVERYTHING they wanted.)
Edit- I think i accidently asked this question in the ND forum, but I am from Illinois..any answeres would still be helpful.
I have BCBSIL and finally figured out that what they want is 'weights and dates'. If you gather your medical records and show copies that show your weight and the date of five years ago (whether it was for a chiropractor or a gyno), it counts. I found I was thinking too hard to try to guess what they wanted. Concentrate on weights and dates to show the five year period. You'd be suprised of the dr visits you had but forgotten until you gather the info. Its ok if you're missing alot in between, just the records that are sanctioned are those that show what you were then until now. I was denied five times until I got this figured out. Don't give up. Once they said I was approved, I had the surgery a week later and don't regret it for a second!