Regence Blue Cross/Blue Shield

Does anyone know how this insurance company is about bariatric surgery? I have a BMI of over 60%, many health issues and I am 37 years old. I have struggled my entire life to lose weight. And I succesfully lost weight many times, but only to gain it back and then some each time. I am so freaking fat right now that I am so far from living a normal life. Just chores like tying my shoes or going to check the mail are difficult. I have only had this insurance since Feb of this year. There is a 6 month pre existing clause on the policy. I have a doctor that I have seen for many years. She is in support of me having this surgery done. I want to have this surgery done right away. But I know that I would not qualify for at least a couple more months (due to the 6 month pre existing factor). What can I do to speed up this process? Do you know how my insurance company is with approving this surgery? Any advice? Tips? Thanks Sherry

I'm not real insurance saavy, but do have Regence Blue Cross/Bllue Shielf. I suppose it depends each each policy. I work for the state of Oregon--bariatric surgery began being covered as of 1/1/06. I went to the orientation in October 2005 and started going through testing, evaluations, etc. as soon as the coverage began. I had my surgery 5/10/06. Everything went smooth for me. Good luck Sherry. I'd love to hear your proress, just don't give up! Debby Surgery date 5/10/06 Surgeon - Emma Patterson

Hi Debby! I had my surgery the day before you with Dr. Hong. I'm part of the State employee program too! I'd LOVE to hear more from you ... maybe we could compare notes since we are only a day apart!!! Deanna

Cool, I'm doing good, had a little down day yesterday, but I think I'm bored being at home. Gonna get out tomorrow and walk around the mall. This all went so much better and faster than I imagined. I'm so excited and ready to do things I haven't done in so many years. Yes--let's keep in contact and keep me posted as to how are you doing?

Hi all. I'm another state worker (well retired that is). A friend and I are going thru the process and have a date of June 20 with Dr. Hong. Can't wait, just found out today. As far as BC/BS, just get started, they are no longer requiring the 6 months nutrional counseling, but are requiring the loss of 5% of your excess weight, or at least that was our deal. All us State workers (ie BC/BS babies) should stick together ......it's been a long time coming. Hope all you post oper's are doing great. You'll be hearing from me with questions I'm sure... Terri

Hi Terri, I found out 4 1/2 months into my 6 months wait that I could go ahead and have the surgery rather than wait so I had about 3 weeks to prepare and complete losing the 5 % of my total weight (not excess). It's amazing how fast the time goes by and you are there in the short stay waiting to go to surgery. Although leary because it's SURGERY, I was smiles almost the whole time. The only difficulty I had was when they first had me get up. Once I got the hang of how to not twist--it was not a problem. I was amazed at how caring every single person was at Legacy. They were all over the top! Debby

Hi Terri! Congratulations on your appointment with Dr. Hong! How exciting! I'm 2 weeks post op (I had Dr. Hong too) and I'm also part of the BC/BS State people! I think there are a bunch of us! Anyway, I also live in Salem and I wanted to let you know there is a support group meeting at the Salem Hospital on the 3rd Wednesday of every month. I've gone a couple times and it's wonderful to talk with people that can offer up words of wisdom! I hope that you will join us ... we'd love to have you there! Deanna

Hi Terri! I know a couple folks at work thinking about this but confused about some things. Trying to get them to post here so you and some of the others who are going through it or have gone through it with this insurance can walk them through some questions. One question I know one friend has is about co-morbidities. BCBS told her they had a whole list of accepted co-morbidities listed but they don't - they just have a vague description. Did you receive a packet of info on this stuff? Dina

Hey Girl......you are looking soooooo good. I'm so proud of you....I am so excited myself. I got a surgery date this week from the surgeon. JUNE 20!!!!!!! Here I come. all you losers, open up the door for one more. Now on to your questions about BCBS....ugh!!!!. No I did not get a packet f rom them. I got most of my information (thank goodness) from the great folks at Oregon Weight Loss and Surgery at Legacy Good Sam in Portland, where I am having my surgery..... What I do know is that 1. you should be 100 lbs over weight, 2. Have a BMI above 48 I think it was, and 3. they look additionally at co-morbities such as sleep apnea, high blood pressure, high cholestoral, diabetes, heart conditions, lung conditions, asthma, etc. They were requring a 6 month pre surgery time span, where they wanted you being seen by the nutrionalist, but has since given that up. They now (still) are requiring y ou to lose 5% of your body weight prior to approval of surgery. That weight would be the weight that was recorded at the time y ou went for your first consult for weight loss surgery....either with your own Primary Care Physician, or with an actual obesity clinic type setting. I hope this helps anyone *****ads this, but good luck Sherry and don't be afraid to ask any questions, if I didn't answer them. I am a State Employee Retiree, but I think the BCBS plans for this are pretty much the same across the board. Keep your chin up and keep going.. Terri

Terri - Thanks so much for the info. I have been lazy about getting to my emails or replies. But I shared what I could with my friend at work. I think she is working on getting an appointment up north and will go from there. I hope she is able to get approved. As for your upcoming surgery date - CONGRATULATIONS! June 20th is just right around the corner...it's so exciting! Feel free to email me if you have any questions, but as you already know these forums here are fantastic for information and help. I love my surgery date forum because especially in the beginning we were able to go through things together and really see what was normal and what wasn't. You can question little things to death and not bore those farther out to death with the minutae. Good luck and keep us posted on your journey. I try to at least lurk when I get a chance! Dina