BCBS MA PPO Approval

Just thought I'd let anyone wondering about this plan, the process was extremely quick and easy. My insurance is BCBS of MA PPO, and I think the specific plan is called blue care elect. I work for LMIC, so the plan was through them.  I had a BMI of 40, and the policy is that you need a BMI of 40, or a BMI of 35 w/ a co-morbid (they are specific co-morbids, like sleep apnea, high blood pressure despite the use of medications, diabetes etc). The doctor sent in my info on Monday, and I had approval by Wednesday. 

There was no requirement of a 6 month diet, no long term history of high weight/BMI. I was really worried they would need more history, since I didn't have insurance for the 4 years prior to this plan, so I had no medical history if they had needed it.  I'm pretty surprised at how little they asked for.  This was much less complicated that I expected. I did have to go to one nutrition class/informational session (three hours or so), and have a psyche eval.  Also, my doctor required that I get an endoscopy prior to the surgery. 

Thanks to everyone else that posted stuff about their insurance approval/requirements. It was very useful to me while going through the process myself, so I figured I better post my experience up here to pay it forward. Good luck to everyone seeking approval!

Hi There!

I also have BCBS of MA, but through Cobra. When I called them, they said the same information. That I would have to go to 1 nut eval and have the psyche evaluation...Im already seeing an endocrinologist b/c of my hyperthyroid---

My BMI is 37..i dont have a lot of comorbidities except for gallstones, which my pcp said qualifies me. do u think this would be a prob?

I got paperwork from the insurance today to have the dr fill out... i called the surgeon but there is such a long process..classes...meetings etc. should i seek another dr?

I am so glad to hear this.  The way I read it, it seems pretty straight forward and have called them with a dozen questions and they seemed fine.  I meet with my surgeon and have my psych appt next week also. 

I do have one question ... What types of things should I list when the Surgeons form asks what type of weight loss methods I have done in the past.  I listed weigh****cher for 2 seperate occasion, do I list diet and excercise?  I hate to leave blank spaces but I just don't know what the right answer is. 

From what I understand, the only costs to you would be copays and your hospital co-pay.  Did your Dr indicate that they charge more than the allowed amount or that there would be other fees? 

My Dr does have a 200 fee to get started but that was not really a big deal since I got a really good vibe from him. 

Congratulations to you!  I can't wait to hear about your journey!