Are all Blue Crosses created equal?? Sorry if this is a stupid question...

I have NO idea what to expect IBX (Independence Blue Cross) to ask of me... Are the stipulations the same as for the other BCBS companies, and what are those stipulations? Have any of you dealt with IBX or know anyone who has dealt with IBX? I would like to know exactly what to expect or at the very least have a general idea...

Heather here is IBX medical policy on WLS.  You need to call your customer service number on the back of your card to see if you have coverage for WLS or if there is an exclusion.  If not then the following policy would have to apply    Hope this helps if you need anything else just PM me. Vicki 

Policy:
	Adult Criteria Surgical intervention for morbid obesity in an adult is medically necessary for those who meet ONE of the following medical necessity criteria: A body mass index (BMI) equal to or greater than 40 (refer to Attachment A for BMI Chart) A BMI between 35 and 40 in conjunction with one or more severe comorbidities (eg, hypertension, diabetes [refer to Attachment B for a list of conditions considered to be severe comorbidities]) AND ALL of the following criteria: The individual is 18 years of age or older. The individual has demonstrated a commitment to comprehensive medical and psychologic evaluations both before and after surgery. The individual has agreed to avoid pregnancy for at least one-year postoperatively, and is not currently pregnant, and/or breast feeding. The individual demonstrates decisional capacity. The individual is capable of and willing to adhere to nutritional guidelines postoperatively. The individual provides informed consent to surgical treatment. The individual has a supportive living environment. The individual must participate in one of the following: Physician-supervised nutrition and exercise program (eg, primary physician, Optifast, Medifast) over three months consecutively prior to surgery, whi*****ludes the following: Dietician consultation Low calorie diet Increased physical activity Behavioral modification OR Multidisciplinary surgical preparatory regimen (ie, facility-based, pre-surgical program) designed to improve surgical outcomes, reduce the potential for surgical complications, and establish the ability to comply with postoperative medical care and dietary restrictions, whi*****ludes the following: Reduced-calorie diet Exercise program in order to improve pulmonary status Behavioral modification program AND ONE of the following operations is planned for the individual: Vertical-banded gastroplasty Adjustable gastric banding Gastric bypass with short limb (proximal) (150 cm or less) Gastric bypass with long limb (distal) (greater than 150 cm) Biliopancreatic diversion Biliopancreatic bypass with duodenal switch Adolescent Criteria Surgical intervention for morbid obesity in an adolescent is medically necessary for those who meet ONE of the following medical necessity criteria: A BMI of greater than 50 A BMI of greater than 40 with obesity-related comorbidities AND ALL of the following criteria: The individual has attained or nearly attained physiologic maturity as defined by the following: Has attained Tanner Stage IV (skeletal and sexual maturation is almost complete; refer to Attachment C for the Tanner Staging System criteria) Has attained 95% of adult height based on estimates from radiologic bone age The individual has demonstrated a commitment to comprehensive medical and psychologic evaluations both before and after surgery. The individual has agreed to avoid pregnancy for at least one year postoperatively, and is not currently pregnant, and/or breast feeding. The individual demonstrates decisional capacity. The individual is capable of and willing to adhere to nutritional guidelines postoperatively. The individual provides informed consent to surgical treatment. The individual has a supportive family environment. The individual must participate in one of the following: Physician-supervised nutrition and exercise program (eg, primary physician, Optifast, Medifast) over three months consecutively prior to surgery, whi*****ludes the following: Dietician consultation Low calorie diet Increased physical activity Behavioral modification OR Multidisciplinary surgical preparatory regimen (ie, facility-based, pre-surgical program) designed to improve surgical outcomes, reduce the potential for surgical complications, and establish the ability to comply with post-operative medical care and dietary restrictions, whi*****ludes the following: Reduced-calorie diet Exercise program in order to improve pulmonary status Behavioral modification program AND ONE of the following operations is planned for the individual: Vertical-banded gastroplasty Gastric bypass with short limb (proximal) (150 cm or less) Gastric bypass with long limb (distal) (greater than 150 cm)

Thank you SO much!!