Blue Cross Blue Shielld Federal for Revison from Sleeve to DS Bad News

Virgie Tschirhart
on 2/20/13 9:46 am - Midwest City, OK
RNY on 12/27/17

I was told that my BMI must be 35 or more for the past 2 years in order for Blue Cross Blue Shield Federal to cover the surgery.  

My BMI was 34 back in 2012.  So, the office new patient rep said Dr. Stewart cannot do my surgery.  

 

Has this happened to any of you?  

Virgie Tschirhart

Lap Band - 2008, Sleeve - 2009, RYN - 2017

Started Program Weight July 13, 2017 - 194.2

Before Surgery Weight December 27, 2017 - 185.0

Current Weight - February 2018 - 161.0

Valerie G.
on 2/20/13 10:07 am - Northwest Mountains, GA

That's pretty standard, actually.  To qualify for WLS in general, you need a BMI of 40, or 35 with comorbities, so the comorbs may be your loophole.

Valerie
DS 2005

There is room on this earth for all of God's creatures..
next to the mashed potatoes

Virgie Tschirhart
on 2/20/13 10:19 am - Midwest City, OK
RNY on 12/27/17

Hi Valerie,  I do have the co morbidities type II diabetes, high blood pressure.  He said the 184 lbs in 2012 was the problem.  

Virgie Tschirhart

Lap Band - 2008, Sleeve - 2009, RYN - 2017

Started Program Weight July 13, 2017 - 194.2

Before Surgery Weight December 27, 2017 - 185.0

Current Weight - February 2018 - 161.0

Valerie G.
on 2/20/13 8:37 pm - Northwest Mountains, GA

If you've had a BMIof 35 for 2 years, with those comorbs. you may stand a fighting chance.  Look to read the policy yourself.

Valerie
DS 2005

There is room on this earth for all of God's creatures..
next to the mashed potatoes

fattynNC
on 2/20/13 12:04 pm
DS on 08/28/12

Are you sure that you are as tall as you think you are?  As I aged I became a little shorter.  I was almost 5-6" and called myself that.  But I was actually 5-5", so that made my BMI much higher.  Verify your height just to be sure.

Virgie Tschirhart
on 2/21/13 10:25 am - Midwest City, OK
RNY on 12/27/17

You know I believe that you could be right.  I'm going to recheck my height.  

I appreciate you input.

 

 

Virgie Tschirhart

Lap Band - 2008, Sleeve - 2009, RYN - 2017

Started Program Weight July 13, 2017 - 194.2

Before Surgery Weight December 27, 2017 - 185.0

Current Weight - February 2018 - 161.0

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