BCBS NE Insurance Question

Hey folks, My insurance is BCBS New England. They offered me a Health Coach that I talk to once a week about nutrition and exercise goal/progress. It seems like a good program form a motivational standpoint but I know I got 'flagged' to have the program extended to me because of my referral or application for wls. I agreed to do the program because I think it will help but I was also afraid that declining would hurt my approval process. On the flip side I am still worried that something I say or do during the program could hurt my chances of geting approved. Has anyone else been offered or perhaps joined this program? Did it have an impact on getting approved? If there is no catch then kudos to Blue Cross for providing such a great service to their members. Thanks, Cher

Hi Cher They offered me one for Diabeties, I declined as I had never been formally diagnosed as a diabetic, I was pre-diabetic as I understood although my sugar is normal now. I'm not sure if I have BCBS NE but I do have some sort of BCBS in MA. From what I unserstand it's a free service that you are under no obligation to partake in nor will it effect your approval. Are you working w/ a Nutritionist at your surgeons office? If so you can tell them that you are working w/ them. They have really stepped up their service, through my husbands employer we have an excellent policy that covered my surgery 100% plus my hubby is looking to have it done in the spring. Good luck Gwen

Hi Gwen, Thanks for the info. It does sound like the same insurance company. I met with the nutritionist at the surgeon's office and everyone there is great. I'll continue the health coach program that BCBS is offering and I'm glad that it sounds like there isn't a 'catch.' I will be so glad when I get my date and everything is in order. I've been working on taking off some pounds before then to be in the best shape possible for surgery and to not get postponed for a weight gain. I feel like I am in limbo until my date is set. Planning vacations, career changes and even buying Sox tickets are all on hold until I get this all set. By the way...I took a look at your profile updates and you are doing fantastic! Take Care, Cher

When is your next appointment w/ Dr. G? Do you have to do a sleep study? I go up on feb 9th a little early for my 6 month follow up. Thanks for the kind words, I think I am down about 93 pds now, I haven't weighed in over a week cause I've been on a plateau. I'm hoping to be down 100pds for my appointment but even if I'm not I'll be okay with that. You'll have your date before you know it and be making all kinds of plans. My DH has his consult in April. Good Luck PM me if you need anything. Gwen

Hi Cher, I have BCBS out of state (NY) and the health coach is just something they offer...a couple of years ago I had filled out an questionaire and they called me...I signed up and stayed with it for a couple of months then I stopped....When I deceided to have the lap band I called BCBS before I even made the appointment with the Surgeon, I called and they told me as long as the DR feels it is medicaly neccessary they will approve and they did!! I was banded one week ago today!! When I got approval, they assigned an RN to my case.. She called me a couple of nights before my surgery and asked me a bunch of questions, offered some advised told me she would be contacting the hospital after my surgery to make sure all my needs are being met. gave me her name and number to call her if I needed anything..... Best of luck!! Jean

Thank you Jean. That all sounds like very good news. I know they are a business but they do seem to have a lot of good things that they offer members. My health coach even sent me some pamphlets and a tape measure to take my measurements. I feel so much better that it does not sound like something set up to prevent my approval.

Jean, I noticed you had Lap Band surgery. I have a few questions about it. I am going to the nutritionist 02/09/07. I have Dr. Hess QMC. Has the LapBand been successful? I have 150lbs to loose. I am worried that I will be able to eat like I do know. I have been assured that I won't but I still worry. What has been you experience? How has your eating lifestyle changed? How did you feel after surgery? Hope to hear from you. I also have BCBS and have tried the program w/the weightloss coach. It is good, but I didn't even think they will call back again. It didn't really work for me, but the coach was very nice. Diane

I'm invoved with BCBS HMO Blue they called and I got involved (for several months prior). My nurse was very supportive the program took me right to two days prior I am two weeks on the other side. The process was great she sent me all kinds of reading material to support better eating habits, excercize. I didn't appear to me that one closely watched the other it had no real bearing on my surgery in fact my nurse told me that she couldn't be involved after the surgery. I successfully completed the program (certificate and all). It worked well for me it was just one more support tool for me to utilize and help me to really accept my decision. She was great I hope your experience will be as helpful.

This was the exact thoughts I had when they called and offered me the Health Coach too. I thought for sure I was going to ruin my chances of approval if I declined. The coach was really nice, and I was totally upfront with her. I told her I was in the process of getting my paperwork together for WLS and she was grateful for the info. I asked her if this is something she is going to report to the insurance company and she assured me that the info I give her will have no bearing on the approval process. I told her I would work with her until I recieved an approval or denial and she agreed that would be best. She also mentioned that if I was approved she could be on hand to help with any pre-op weight I needed to lose. In the end, my involvement had no weight on the decision of the insurance company to approve me or not. I was approved after 1 week and I cancelled my participation in the program 2 months after I started since she wasn't really helping me that much. So I just wanted to put your mind at ease. Feel free to be upfront with your coach so they know what you are up against. Good Luck Crystal