Heard back fro BCBS of IL

For all of you wonderful friends that sent up a prayer for me when I asked last month, Thank You. Unfortunately, BCBS of IL sent back this response: "Bariatric Surgery would not be eligible under your health care plan because No medical documentation of 12 consecutive months of successful nonsurgical weight management....." EXCUUUUSE ME!!!! If I was SUCCESSFUL, I would not need surgery!!! Never fear...the appeal letter is almost ready to be mailed. I'll keep you all posted on my progress, and thanks again for all of you support! Dawn

They did the same thing to me also dear and I had to do the 12 months of dieting but they did me really nasty. Sent a letter stating only 6 months of dieting and then never informed me that they changed it to 12 months until I went to get my surgery. BCBS of Il are a bunch of jerks. They even turned down paying my surgeon after they told me it was approved and I already had the surgery so I paid out of pocket to my wonderful surgeon Donna

One last thing Dawn, While your waiting to hear about your appeal letter keep seeing your PCP are they might throw it up in your face that you have a break in that 12 months of dieting and try to turn you down. I kept going to my PCP. Best of luck Donna

Hi Dawn: I, too, am fighting with BCBS of IL. I have been doing this for two years now. Funny thing is, my letter says I have to have evidence of a "failed" 12 months of medicaly supervised dieting. I don't get it! I just overnighted a new package to them yesterday. They are a tricky bunch!

Dear Carolina: I still haven't hear back on my appeal, but when I called to check on it last week, the woman that answered the phone began to read me a denial letter that sounded exactly the same as the first one, except it said "unsuccessful" (or maybe "failed"). I told her that it sounded like they did not even LOOK at or READ the appeal. She put me on hold for a whlie, then came back and said to totally disregard what she had read, and that if I were to get a copy in the mail, to also disregard that. She said that she was reading from a letter that had "mistakenly" been sent to answer my first submission. I think someone caught their mistake in using the word "successful" and was trying to cover their tracks. She then went on to tell me how they had received my appeal and it was being handled and I should "hear something soon". I will be calling again by the end of the week to see what their story is THIS week. In the mean time, yes, I am seeing my pcp every month and will have 5 months in by the end of April. My pcp thinks this is all crazy and will be calling them herself if the appeal is denied. Do you have your 12 months in now? Good luck on your journey and let me know how it turns out! Dawn