Blue Cross Blue Shield Federal & How Long Approval Time?

Hi All,

I have Blue Cross Blue Shield Federal Basic and I am submitting my paper work on Tuesday for VSG. I just wanted to see from others about how long it takes to get approved?

Also did they make you do a Sleep Study? I was told that my insurance called my surgeon and told them I needed a Sleep Study. I have never heard that! So now I'm doing it tonight! And scared for whatever reason! :)

Anyway let me know your thoughts! 

Thanks, Kim

 I have BCBS standard and the approval came back within a week.  I think it was 4 days.  No studies, no required supervised diets.  I had a BMI of 44.4 with no co-morbidities.

Aw Thanks hun! I have been so nervous everyday as it is!! It happened so quick and they told me I didn't need 6 mo. diet! I was just so excited! That's a pain!  

I have BCBS Fed Standard and it took 4 days.  Mine is also not 100% paid.  Your plan may differ, but my out of pocket cost was 15% - BMI 37 with 2 co-morbidities.

Yeah with the basic I only have to pay I think $100 co pay at the hospital. 15% is alot! I hope I find out sooner then later! Thanks!

I'm not one of the lucky ones.  I have bcbs fed standard.  I had a revision from lap band to vsg.  bcbs fed paid for the removal of the lap band, but said no to the VSG.  I appealed it and I'm waiting for the answer I 'm supposed to get a letter stating what their decision is on the appeal.  

The reason for denial was that I did not meet the medical criteria.  Whatever that means.  I had to ask in writing for a more specific detailed reason.  Plus my doc gave a letter of medical necessity.  Hopefully, they will reconsider.    I had   the surgery already and did self-pay.  I'm just trying to get reimbursed. 

You will be different , since you did not have a revision.  I also know that some people in different states had no problem getting approval.  It really should not matter what state we are in being that it's federal.    

I wish you the best my dear.  You are your hubby and a very cute couple.....  I know you are gonna love the SLEEVE!!!!

BLESSINGS
babygirlinokc 

  

Oh wow I wish you luck!!! I mean that's alot of money to have it done and I pray bcbs does the right thing!

AWW Thank you! You made me tear up a little when I read that were a cute couple! That's very sweet! I like to think we are but there are haters out there that just look at the big girl with the hot guy! But that's not why I'm doing this! I'm doing this for me! I want to be healthly again!

Kim

I started my journey to WLS back in August 2008. I wanted it to be done at Johns Hopkins Hospital in Baltimore. I have BCBS Federal - I think the standard plan and was denied due to the VSG being "experimental" and that I had a low BMI. BUT what really blew my mind is that they approved for me to have the lapband procedure or the gastric bypass. I didn't want either so I ended up going to Mexico and paying out-of-pocket. Is BCBS now approving the VSG procedure these days???

I don't know. I called and they told me they do the VSG now as of 01/01/2008. I don't understand how some people can have it and some don't! You should submit your paper work and see!! 

Thanks!