BCBS OF TX

Has anyone had and luck getting BCBS of TX to pay for WLS (Gastric Bypass)?
I haven't submitted my info for approval yet, just waiting on my "3 months of active participation in a weight loss program" to be up.

That's the same insurance I have and am working on my 3-months of physician supervised weight loss.  I'm very interested too if anyone has any experience with this insurance company.

Warriormom,
Do you have to have 3 months of a physician supervised weight loss program?? On my policy it just says: Evidence that comprehensive non-surgical treatment of morbid obesity has been attempted prior to surgical treatment of morbid obesity: A program will be considered appropriate if it includes ALL of the following components: Nutritional therapy, which may include medical nutrition therapy such as a very low calorie diet such as MediFast™ and OptiFast™ or a recognized commercial diet-based weight loss program such as Weigh****chers™, Jenny Craig™, etc.

I talked to 3 different people at BCBS of TX to make sure that Weigh****chers online would meet the criteria and they all said that they thought it would...but I know that doesn't amount to a hill of beans when it comes time for approval.  I'm a month into the WW online and i've already had my psych evaluation and my doctor consult but I'm just sooo nervous that they aren't gonna approve me!
 

That's the same thing I've read.  I need to take the insurance statement in with me at my next appointment to make sure my doctor covers all the things listed. 

I don't know if WW on-line will count or not.  Are you seeing your doctor too?  If so, he would be able to document the weight loss.  I just don't know how that will be done if you're doing it on-line.  Maybe you can get someone a BCBS of TX to send you an e-mail confirming that is will count.  I would hate for you to get 3 months down the road and them say that it's not enough.

Yes i've already seen my doctor for the consult and they all said that WW online should be fine...I sure hope so!   You're right, I should get them to confirm that in an email, although I did get a name when I talked to someone there. We shall see! =)

My Drs. office just submitted my paper work onWed to BCBS of TX they said it could take up to 2 weeks to hear back form them..We shall see Im getting a revision so I only had to do the Psyc evelation cause the notes form my Band dr was enough for my 3 months...........Good luck

Hi all.  I too have BCBS TX (via TRS).  I was required to do the three consecutive months of supervised weight loss program with my primary care physician.  The original wording in the requirements letter was confusing to me, so I called the insurance co. and my surgeon's office for clarification and was told by both that I had to do the 3 mos. consecutive visits.

I've now completed ALL the requirements on my letter and my paperwork was submitted last Monday.  I was also told it usually takes them 2-3 weeks to get back with an approval or denial. 

I've got my fingers crossed! 

PS...I was sad to find out that VSG is not covered by my BCBS TX plan via TRS, so I opted for RNY.  This may turn out to be better for me anyway!

If any of you hear back, please post thier response to your submission!

Thanks for the posts.  I'm anxious to hear how your approval process goes.  Hopefully, we'll all get approved quickly and easily.

Keep posting with updates.

I have BCBS of TX (PPO) and I had to do the three month supervised diet as well.  It took about a week to get my approval from the time it was submitted.

Thats GREAT news Cowboy mine was submitted on Wednesday so I'm hopeing I will know something by this Friday Do you have a date yet??? Congrats