BCBS IL Update

After waiting for 2 weeks, I got a letter from BCBS. I was really surprised as the surgeons office said it would talk 30 days. But here it was. I open it to find a form letter. Not a denial, just an overview of what is needed for approval. What the heck I know all that stuff and it was all sent in. It was like they didn't even read the information that was provided. I can't wait until tomorrow so I can call my surgeons office to find out what next? The fight is not over

Hi Ronna....my name is Sharon and I live in Delaware. I too have BCBSofIL and was just denied on Friday, 3 days before surgery, that I was denied. They want the 12 months of supervised diet, 5 yrs of medical records...they got records since early 02. I am so frustrated! I cried the rest of the day on friday and slept most on saturday! Why should BCBSofIL be so difficult. I don't hear this about other BCBS's. My surgeons office said that ours is very difficult. I am ok with doing 5 more months of diet monitoring but i'm afraid of a new year/new policy. What other hoops are they gonna make me jump through. I had to go through 6 weeks of classes, all of the clearances and they still denied me. I have a bmi of 51.5 and lots of medical problems that makes me a canidate for surgery. I guess i have to near death to be considered! Sorry for venting but I have been looking all over this site for help. I came to this messageboard and saw your posting. Hope things work out for you. You will be in my prayers. Email me anytime. Sharon B

Boy Sharon, I am sorry. Don't give up. Go to their website www.bcbsil.com and then go to the providers tab. They do have the policy listed for "surgical treatment for morbid obesity." That will give you their entire criteria. That way you won't have any more surprises. Good luck and regards, Ronna

I have Aetna. I waited about 4 weeks of being told they had all of my paperwork and when I finally spoke to the nurse reviewing my case they had only recieved a few pages of it. I would make sure they have all of the paperwork. Once they recieved all of my paperwork I was approved that day!! Susan

Thanks Susan, I talked to Karen who is the Insurance Coordinator at my surgeon's office. She said she would follow up but needed the letter (hadn't gotten her copy yet). I will give it until tomorrow and I will call again to see what's up. If all else fails, I may just go with my Medicare alone. I know I will have to pay more out of pocket, but I don't want to wait until next summer for the surgery. We shall see. Thanks again for your input. Regards and hugs, Ronna

That insurance company is a JOKE from the word go. I have BCBS of IL and they have done nothing but screwed me over and are still screwing me over even after I had my surgery almost a year ago. They approved my surgery and paid for it and now they took the money back from my surgeon because they said my husbands company did not cover WLS. Everytime I called that insurance company I got a difference song and dance and i could call five times in the same day on the same matter and still different story. Donna 338/174

I agree with you Donna. There are going to be many changes in my coverage once my Medicare kicks in next month. In fact they advised me that begining next year they will no longer be provideding RX coverage so I will be dropping them anyway. So now there is no question. It's Medicare all the way for me. Wish me luck. Ronna

I wish you all the luck in the wrold my dear Donna 338/174

I'm right there with you. I see my Family Doctor tomorrow for my last of the twelve months "failed" medically supervised dieting. I've been to the psychiatrist not associated with my surgeon's program. I'm a couple of months short on the five years -- I'm just waiting to see what obstacle they'll throw at me next. A friend of mine is going through this with BCBS of Texas also. It seems their policy mirrors BCBS of IL. Good luck! Don't give up!

Carolina, I have BCBS of IL - I've got to have that 'failed' diet to. I have 2 more months. Please let me know how long it takes you go get everything in. Thanks! Beth M