Empire BC/BS of New York

I have just started the WLS process and am hoping to have LapBand surgery.  I have attended the seminar, had my insurance verify coverage, and have been accepted into the program with an estimated surgery date of February 2009.  I am having my surgery in Illinois, but my insurer is Empire BC/BS of New York.  Can anyone share their experiences with this company?  I cannot tell from the literature whether they require the 6 months of medically supervised weight loss, but I'm doing it anyway.  Any information will be helpful!  Thanks -

 

 

Hi!
I have Empire too and they do require documented weigh in's from a doctor for 6 months showing you are losing weight. There may be some flexibility based on co-morbidities of your situation, but I was told that was their big sticking point to make sure people were good candidates for surgery.
Good luck with everything!

Thanks - and congrats on making it through surgery with flying colors!

I could just kick myself for not having my PCP document my weight loss attempts over the last 5 years....and for waiting 4 years to  talk to him about surgery after I first started thinking about it!  I have hypertension and a VERY STRONG family history of heart disease that took my grandfathers' lives at ages 39 and 60, and my dad at age 60.  No diabetes, no sleep apnea, or arthritis but I'm only 37.  I also have MS, which is not really a co-morbidity but the excess weight will definitely affect my  mobility as the disease progresses.  Did you see a dietitian during your 6 months with your doc?  Mine seems ok with tracking my progress himself, but I don't want that to cause any problems with getting approved.

Thanks again for your info!

Dont they take your vitals...height,weight, temp, pulse, b/p...every time you go in???  Most do, they can print that off for you!

Hello....welcome to the boards.  You will love it here.  There are a whole bunch of wonderful people and tons and tons of valuable information.  I have BCBS and they required 6 month supervised diet.  Good luck to you. 

I have BC/BS of MN and they do, as well as NY, require it.  I was denied at first because I did not have that documentation...  My doc had no problem getting it to them because I have been going to him for a long time due to my weight, all I sent was a list of my vitals including my weight they had for the past 2 years...they accepted that along w/a letter of reccomendation.  Good luck!!!

Honestly....up until 3 years ago I was probably the HEALTHIEST fat person on the face of the planet!  I rarely went to the doctor even for a cold.  I did go a few times for migraines, but I doubt seriously that they weighed me on those visits.  They're gathering my records as we speak, and if they don't have at least one progress note from each calendar year, I am going to have to get some from my Gyno - I know I saw her every year! The WLS center doesn't seem too inclined to submit without the 6 months - they've seen too many denials. Financially I can't do the surgery until after the first of the year (new medical spending account), so I may as well keep seeing my doc in the meantime.  I am trying really hard to have at least a 10% loss by then.

I have Empire BC/BS through the State of NY. They required that I show that I tried to lose weight over a period of time. Also what helped me is that United health Care Covers the Surgeon portion of the insurance and they approved it first sent the approval to Empire BC/BS which covers the hospital stay and because United Health Care approved it  Empire did!!!!!
Good luck on your journey.

I got my all my approvals today and my surgery is this WED!!!!!!!