What insurance did you have when approved for DS

Cigna

but i can concur that smaller companies sometimes have exclsusions..   heck i work for a WORLDWIDE company and mine still had some exclusions..  luckly i was able to figure around them  =)

Most plans with Blue Cross Blue Shield require a starting BMI and perhaps a 3 year history of a BMI over 50 for the DS. The Federal BCBS may not, but many of the commercial plans do.

I was approved through a sub-group of United Health Care plan 2007 with a BMI of 36.8 and 5 comorbidities.

Oxford Freedom Plan

My insurance required nothing if the BMI was > 40 so i was quickly approved.

I have Aetna.

I am a revision patient. I had Aetna in 2002 and they approved RNY it took 2 months. They had a minimum BMI requiement of 40 mine was 47 no comorbidities.

Fast forward 10 years. I now have Anthem BCBS and Tricare Standard as a secondary. Both approved revision surgery no BMI requirement. I am back up to 39. I have marginal ulsters, dumping syndrome, and hyedal hernia. They approved in 2 weeks.

I am scheduled for surgery 12/10 with Dr. Keshishian.

Best,

Good Luck

Whit

BCBS-TN approved me on the first try with no comorbidities seven years ago.  I only paid my surgeon's "program fee."

After a year long all out FIGHT with Cigna and five appeals with an external review Cigna approved my husband because the reviewer said they had to.  He weighted 415 lbs.  Their criteria is a 60 BMI, which is ludicrous. He wasn't quite there and that's why they denied him.  He had his surgery in October and it only cost us 1700, which is our out of pocket maximum.

Our plan at work is handled through Carefirst Administrators. It is a nationwide BCBS plan that Carefirst manages.

So I'm always torn about if I should list Carefirst as my provider or BCBS.

I was approved upon the first insurance submission. Our plan required six months of weight loss visits but they didn't have to be consecutive and there wasn't a required BMI for the DS (but I would have made it had there been one). In fact our plan was strange (to me) because it didn't have anything that said we cover these specific surgeries and don't cover these others. There was no listing of covered procedures or any differences in the requirements depending upon which surgery you'd request. The nurse that approves the procedures told me to submit it for the one I wanted and we'd find out afterwards if it was covered or not (which seemed really weird to me). I was glad that my surgeon's office was able to confirm in advance that the DS is a covered procedure so I wasn't on pins and needles for months.

The other odd thing I thought about the process is they don't just say yes you've been approved or no you haven't. They read me this huge disclosure. The lady was ready to hang up as soon as she finished saying it and I was still sitting there wondering what the heck she had just told me. I had to ask her to explain it in normal terms as I'd never gone through a pre-certification process before.

I have BCBS of Kansas, FEP for federal employees through hubby. I have some co-pays but I am not complaining one bit. They approved me about 15 days from paper work being sent in. Oh and we have the BASIC plan. Hope this helps and good luck to you;)

Kaiser Permanente in California.