BCBS MI = Making Me Mad!

I am so upset right now. I read on the criteria sheet that there is a possibility of waiving the 6 month diet due to having a BMI higher of 50. I called BCBS of MI to get clarification about that possibility and she said well of course you would be able to do that but you have to have the Sleeve first as the first step on towards a gastric bypass. Are you kidding me? Does this CSR know what she is talking about? I am so furious, I am sorry but I don’t want a sleeve and then go back in and do a Lap. What should I do?

I would call and ask someone the same question. And then If they still said to do the sleeve.. I would just wait the 6months! Most of us have done it...Trust me girl it flys by.

I'm actually trying to get the sleeve through BCBS-MI so this is actually some good news for me. I don't have the diet history and am on a time crunch, but my BMI has hovered between 50&52 between the surgeon and the PCP's scales and charts. They just submitted my paperwork today for approval. I hope I get approved now.

Yay I am glad my bad news is your great news!

Nichole, BCBS if your BMI is over 50 they feel the gastric sleeve is a more effective weight loss for someone with a high BMI and that was what they wanted me to do or the RNY and I wasnt a candidate.  I fought them and one and got the lapband with a BMI of 65 and I am a little over a year out and over 108 lbs lost.  Dont let them dictate your surgery if you have WLS coverage you fight them tooth and nail to get the surgery that is best suited for you my dear.  I f you need help then contact me via PM or my email is on my profile

Thank you so much. I appreciate the help! I am going to call again and see if I get a different CSR.

I have BCBSM too.  My surgeon's ofc called me on Thursday to say they received my psych eval but not my PCP's notes. I rattled my PCP's cage and they faxed them to the surgeon's ofc that night. On Friday (yesterday) the surgeon's ofc called to say that they have everything and my file will go on to the insurance authorization department. Then, after lunch I got a call saying I was approved for my RNY. Is your procedure still considered FDA experimental? 

Both my sister and I had RNY.  I had to do the 6 month diet.  My BMI was 42.  Hers was 53, she did not have to do the diet, nor did they say anything to her about the sleeve.  We both have the same ins, BCBSM.  I would talk to your surgeon about this.  See what he says.  He or she has done many of these, so they would know.  I think you got someone new.  Or, call back and speak to someone else.

Erica