BCBS of IL-dr. supv. diet requirement

Teresa C.
on 10/25/09 7:59 am
I will travel if i need to but i live in Kentucky but my husband's company is out of Michigan so that is the insurance we have.  My plans are to have surgery in Lexington, KY

Teresa AKA tjcteacher

                
Lifeski
on 10/25/09 9:21 pm, edited 10/25/09 9:22 pm
BCBSIL changed their 6 month requirement to a 3 month requirement in July.   At that point they also did away with the 5 year history of obesity.   The changes they made in Sept involved the DS.  Good luck.  I am working on approval now with them.  Below is the link to the details but make sure and check to see if your paticuliar policy includes weight loss surgery.  Not all do.

http://medicalpolicy.hcsc.net/medicalpolicy/home?ctype=POLICY&cat=Surgery&path=/templatedata/medpolicies/POLICY/data/SURGERY/SUR716.003_2009-09-15#hlink

Teresa
HW-293                     SW-290                    
      
Tonya75
on 10/28/09 5:11 am - IL
BCBSIL change policy to 3 months.

I was approved for RNY, but when they changed the policy to cover DS, I immediate had my doctors off send paperwork for the DS.  I was approved right away.

Good luck with your submission!

DS Surgery 11/23/09
Tonya
 
                  
Laura A.
on 10/28/09 8:42 am
Thanks Tonya. I know for sure now that it is a 3 month requirement. I go see Dr Gomez on this coming Tuesday to be put on whatever plan she deems necessary for me. Guess I won't be enjoying the holidays this year! LOL! That's awesome you got approved sooo fast!!  Laura :)
MugsyMann
on 3/19/10 1:16 pm - Keller, TX
I have BCBS IL.  They now require a 3 month supervised diet/ exercise program.  They changed it from 6 months to 3 months when I had only 2 months left in my 6 month program.  
Laura A.
on 3/20/10 12:15 am, edited 3/20/10 12:16 am
Hi, I went for what I thought was my final visit to Dr Gomez  in February (at the end of my 3 month program), and they told me it had been changed back to a 6 month requirement!!!!!!  Said there was someone new in charge and they were denying everyone who only did the 3 month program.  So now it will be May before I complete the Dr supervised diet!  Husband works for UPS and this is according to his insurance and to Dr Gomez. UPS has Aetna insurance for outpatient/doctor's fees and BCBS of IL for inpatient/hospitalization.  So when I called BCBS they told me if Aetna would pay for the doctor's fees they would pay for the surgery and hospitalization.  Soooo confusing, but I figure Dr Gomez and Dr Jones have been doing this long enuf to know what I need to do to get approved (hopefully, anyway) .  Sincerely, Laura
(deactivated member)
on 3/20/10 3:20 am - AZ
BC/BS has varying plans. They are not all created equally. One is a 3 month medically supervised diet, one is a 6 month diet, and one is a 5 year history of MO. It depends on the state and the specific policy. There is no one major change for all policies.
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