BCBS of NC DS approval!?!

Jessie K.
on 9/12/10 7:54 pm
Does anyone have any advice on insurance approval for DS through BCBS of NC?! Some ppl are saying that it's absolutely not covered,but online it looks at best like a maybe. I can't afford this surgery on my own.  Ayudame.  :(

     

Lilypie Pregnancy tickers
Barbara C.
on 9/12/10 10:16 pm - Raleigh, NC

Jessie,

I would suggest contacting your Dr's insurance specialist, your insurance carrier and see about cross-posting to the insurance, main and DS boards to see if you can find others that have managed this with BCBSNC. I'd want to know what their guidelines are. Sometimes insurance carriers have restrictions on what your BMI needs to be before they will approve. If so, what are they? i.e, a BMI over 50? 

Wishing you all the best,

Barbara
ObesityHelp Coach and Support Group Leader
http://www.obesityhelp.com/group/bcumbo_group/
High-264, Current-148, Goal-145

Missy1975
on 9/13/10 11:03 am - Graham, NC
I also have BCBSNC and am trying to get the DS approved right now.  It is a covered benefit.  You can go to BCBSNC's website and look at Medical policy for the DS.  It does say that BMI must be 50 or higher.  I am a 40 so my sugeon sent in a Waiver Request.  If it's denied then I will appeal myself.  Good luck to you!
girlygirl1313
on 9/16/10 4:06 am - Davidson, NC
 I have BCBS of IL and was approved for DS on appeal.  I had a 47 BMI.  I just posted my appeal letter on my profile page if you'd like to see it.
~GG



        

VictoriousSecret
on 9/19/10 7:19 am
I can't help exactly, but wanted to mention that I got approval on the first try with BCBS for roux-en-y. 
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