silly questions

I am filling out this paper work and keep on circling no no no no to everything.  As far as I know I don't have any health problems besides being obese,  do you guys think this will hinder my eligibility for surgery?  Also, the part that  you write your attempts at weight loss...  I am having a hard time with this because I am always attempting weight loss.  I have done weigh****chers and tried atkins and south beach but most of the time its just me dieting on my own.  Its hard to sum up 18 years of weight loss attempts lol.  I know I am probably stressing out over nothing,  I just want everything to go ok :)
(I have blue cross blue shield insurance)

I have heard that BCBS of RI is the easiest one when dealing with WLS.  That was from a secretary at my doctors office, so I think it is valid.

If you have a bmi over 40, you should not need any co-morbidies.  I have none.

Did you see what the guidlines are from your health insurance company? It will clearly state what is required of you.  Call them and ask if you are not sure. 

As far as the WL attempts just give it your best guess.  The only place I see it as an issue is if your insurance requires X amount of time on a supervised diet.  For that you will need proof and records - it might even require doctor notes.

Good Luck!

Thanks so much that puts my mind at ease :)

Here's a link that was useful to me (hoping your BC is also through BCBSRI):


https://www.bcbsri.com/BCBSRIWeb/plansandservices/services/m edical_policies/SurgeryforMorbidObesity.jsp

I not only have BCBSRI for insurance but I also work for the company. I was approved the right off the bat when my paperwork was submitted and my BMI was under 40, with diagnosed sleep apnea. In my experience, as long as you meet the criteria below, they won't give you a problem.

That being said, please remember that even though we all might have BCBSRI for insurance, that there are tons of different policies and levels of coverage that each person might have. Just because one person was approved by them and their policy covers the surgery, does not mean that someone else with the insurance will have the same experience. My best suggestion is to call Customer Service with your policy # and ask them about the coverage for the surgery you are interested in specifically on your policy. Good luck!

Liza

Sorry, I meant to post this criteria too -

Medical Criteria:

Bariatric surgery is considered medically necessary for all product lines when ALL of the following medical are met:

1. BMI of 40 or BMI of 35 with at least one significant co-morbidity (e.g., high blood pressure, diabetes, etc.); AND
2. Documented failure of weight loss attempts; AND
3. Obesity present for at least 5 years; AND
4. No untreated metabolic/endocrine abnormalities; AND
5. Adult (achieved full growth).

Hi Amy,

You've gotten some great replies about the insurance stuff. We have great friends here, huh? No question is a silly one!

When I had to come up with my diet history. I had to think of over 25 years of dieting attempts! Yikes!

I like to keep things a simple as possible...

I went through my photo albums! When I saw pics of myself thinner and became familiar with the timeframe, I remembered what diet I was on that got me there and the approximate season and year.

It was quite depressing and eye-opening but it really helped!

Have a great weekend!

Jules

Hi Amy,

I am just starting the journey as well.  I went for my first consult with the Dr. on Jan 29 and was approved by BCBS within 3 weeks.  I had a bmi of 41 with high cholesterol (barely!) and my doctor asked my what weight loss programs I tried.  I listed them to her and told her nothing was ever documented by my primary doc.  No problems so good luck!