Insurance question

Just wondering if any one had been through surgery with my current situation. Paperwork has been sent  I am waiting on an approval and getting nervous. I have BCBS of TN, my BMI is on the lower side but I have multiple co-morbitities. Any approval stories out there if do give me hope. I want to here the denial stories also but if you don't mid saying I would like to know why you were denied. Thanks

Hi!   I don't have BCBS of Tn, but I am familiar with their guidelines, as I used to get authorizations on procedures thru them for surgery.  

As long as your BMI is 35 with one of these co morbidities - hypertension, diabetes or sleep apnea and you are using a Center for Excellence (hosp and surgeon) approval should not be a problem.   You will have to meet the other criteria guidelines, nutritional eval and psych eval as well.  

Sounds like you right on track!!

good luck, 

Nik

Thanks for your response!!!! 

Click on the magnifying glass in the blue navigation bar on the top of the screen and type "insurance." You'll find plenty of others' stories.

Most people seem to take about 2 weeks between paperwork submitted and hearing a result.

Hey there, I live in NJ and have Horizon BCBS of NJ and was approved for the Surgery (Gastric Sleeve). I am scheduled for the surgery on 02/09/2016 and am currently doing my Pre op diet. My situation is different though in that I have a liver disease and in order to be listed for liver transplant I have to get in shape and lose weight and my Hepatoligist recomended me for the weight loss Surgery. I recived a letter in the mail and everything saying I was approved. If you have an individual health insurance plan like I do you should have benefits for this all though every BCBS plan is different. I happen to have a Platnium Plan with good benefits.

I had a somewhat the same problem. i started my weightloss journey last year April 2015 and i had Meridian insurance then in August 2015 my insurance was changed to HAP Midwet of michigan but in december 2015 HAP Midwest decide not to cover wayne county michigan only oakland county so then again  it was changed to straight medicaid in December 2015 to January 2016it was changed to  Molina insurance and molina does not cover the sleeve they only cover RNY Plus i have to start all over with doctors visits because i miss one month because of all the confusion im so tired and in so much pain im willing to take out a loan and work two jobs to pay it back.