APPROVED-BCBS IL

I AM FINALLY APPROVED!  I am not on here much, but anytime I have posted questions all you guys have really helped and I wanted to share!  I have been trying to get this approved for 3 years and FINALLY with the help of Kelly Lindstrom @ obesityhelp.com BCBS of Illinois approved me!  I just wanted to let everyone out there know to NOT GIVE UP!!  Especially if you are getting jacked around by BCBSIL.  They deny everyone for the same thing (no documentation of 6 months weight loss attempts OR no 5 year history of obesity--I had both)..just keep appealing!  Also, contact obesitylaw.com if you need help. I will let you guys know once I have a date...I just got my letter this afternoon after work so I haven't even gotten to talk to the surgeon's office yet..  

That's great news!

I can't believe it took 3 years to get approved for lapband. Makes me wonder how long I will have to fight with them for DS approval...

They wanted that 6 months supervised weightloss and 5 year morbid obesity!!  I have not had to try with BCBSIL for 3 years, just for a year with them, but my insurance before them denied as well.  Just when you send your stuff in,  make sure you have dr notes showing all that stuff...then don't be discouraged when they deny for you not meeting the criteria....from what I can tell with my research, they deny everyone the first time automatically.  I had 7 years of notes showing history and 24 months of supervised weight loss attempts and they still denied my first request!  I had obesitylaw.com (Walter and Kelly Lindstrom) send my appeal letter and it was approved 2 weeks after they sent the letter(my dr set it up so I didnt have to pay).  But an appeal letter pointing out everything may have worked too, Just keep trying and dont let them win!!! 

Do you know if they cover DS?  My previous insurance called it "investigational" but that was 2 1/2 years ago.

Wow ~ we've had similar experiences. I just sent my medical notes (2002-2009) into the surgeon's office w/ notes from 2 PCP supervised diets (#1 - 2.5 years & #2 - 6 months). I also had a previous insurer deny me based on employer exclusions.

BCBSIL considers DS "experimental" - from what I can see, the oldest journal they base their decision on is from 1998. There have been more studies done since then... Hopefully this will be a point I can bring up on appeal.

When did you send it in?  Make sure you call and follow up a few days after you send it.  The "failed to receive" it twice when I mailed it in.  It was not until I faxed it that they actually acknowledged.  GOOD LUCK!!

I have to call Monday or Tuesday to make sure the surgeon's office received the paperwork & to find out when she sent it into the insurance company. THen I can call the insurance company obsessively to see if they received it.

Thank you for the advice

I am having the same problem with BCBSof IL stating I did not have the 6 month requirement.    Any tips?

Keep me updated.  I will say a little prayer for you.  I know it is so frustrating.  If you need to chat feel free to PM me.

Mandy