BCBSIL
Hello!
I'm very new to this and it's my first post, so I apologize if it's in the wrong location! I'm 24 (I'll be 25 in August) and I've been overweight since I was about 10years old. I'm 5'7 and weigh about 225.
My question is has anyone with similar height and weight been approved by their insurance? If not what did you do?
You will need to calculate your BMI. That is where you will start in determining your candidacy for WLS. The standard requirement by most insurance providers is a BMI above 40, or above 35 with comorbidities such as type II diabetes, high blood pressure, sleep apnea, etc.
You can call the number on your insurance card and check to see if your plan has coverage for WLS. If you are deemed a candidate, you will need to follow your insurance requirements to the letter, so do all of the research you can. If you get turned down, you can appeal the decision. A good surgeon can get approval on the first try if you have met the requirements of your insurance provider.
Hope that helps!
We don't have to agree on anything to be kind to one another...
You currently have a BMI of 35.2. Many insurance companies will cover surgery for a patient with a BMI of 40+, or 35+ with comorbidity such as diabetes or high blood pressure. BUT, every company and plan is different.
Find your benefit book (look online or ask HR) and see what they require. You can also call the customer service number on the back of your insurance card and ask.
Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!
Hello!
I'm very new to this and it's my first post, so I apologize if it's in the wrong location! I'm 24 (I'll be 25 in August) and I've been overweight since I was about 10years old. I'm 5'7 and weigh about 225.
My question is has anyone with similar height and weight been approved by their insurance? If not what did you do?
you need to find out first if YOUR EMPLOYER has bought the rider for bariatric coverage from the insurance co.
If your company has NOT bought the coverage,then no ,BCBS of nowhere will cover WLS for you.
It will be termed an exclusion and there is no way of getting around an exclusion,not even medical necessity.
hey - i have BCBSIL - and i was approved BUT - I was 38, 5'5 275 lbs. Just submit everything and they will tell you if they will approve or not. If not, you need to ask why and see if you can fill their requirements. I was rejected and then had to provide certain paperwork. I was finally approved. it is a long process. good luck :)
