BC/BS federal waiting game

Hopefully today is my last day of waiting to get approval for my revision. I have been going at this for over a year now. Originally we had a scope done on me, found of course that my pouch is two sizes too big and too long. Also have a hiatal hernia and reflux issues along with other junk. So we submitted for approval and was initally denied. I did not have a high enough BMI at the time, yet I had the hernia and co morbidities. We went through the chains all the way up to the bc/bs dr talking to the surgeon....denied... appealed it...denied. All from what was stated that it was "not medically necessary bc the BMI was not high enough".

Well..........so I gained more weight. Got the BMI up to 37. 35 was the required BMI. We resubmitted and tomorrow is the due date of the decision. I am anxious yet worried that they will come up with something else and deny me once again.

Anyone else have this insurance and get approved?

Deb, I don't have bc/bs however I am also in need of a revision because of a gastric fistula, staple disruption, I have Health America who is denying me the surgery, and yet it was their company who approved the original surgery 8 years ago, go figure. I see this as a dropping off point for them, they are playing a game with us, sure you can have your surgery but don't ask for any support if you run into problems down the road, they should all be hung. Shame on our healthcare system, I bet if you came across the border they would take care of you, no problem. Keep the faith, I am trying to and am taking one day at a time. Did you contact obesitylaw.com? If so what happened? I am wanting to have this fixed as I have horrible pain, thought it was an ulcer, and its the hole and acid causing it. Just a pitiful system that we have. Carole