New Insurance Requirements for ME....WHAT?! :-)

Hope everyone is well. I just wanted to share my experience thus far.

In November 2017, I decided to attend a Bariatric Info Session. In December 2017, had my first weigh in, met the surgeon, and first nutrition visit. I was automatically switched to County Care Health Plan and the following are specific requirements for bariatric surgery:

6 nutrition visits (NO referral needed)
Cardiac stress test
EKG
CHX
Pulmonary test
Endoscopy
CBC / CMB
Sleep study

I had the option to select my own health care plan if I did not want County Care Insurance. Therefore, I researched and compared plans based upon the services/co-pays/hospitals/physicians and in January 2018, I selected Illinois Blue Cross Community Health Care. I just called the insurance coordinator to confirm if I needed a referral for the psych evaluation. The coordinator explained, as of 2018 Blue Cross Community Bariatric requirements are:

6 nutrition visits (no referral neeed)
psych evaluation (no referral neeed)
letter of medical necessity
1 support group meeting (surgeon requirement - I attended three)

WHAT?!!! THAT'S IT!? I was still crossing off requirements based on my previous health insurance. So, in two weeks (same day appointment) I will have 6th nutrition visit, pysch evaluation, surgery date, and finally weigh in prior to insurance submission. Quite sure surgeon wants a cardiac stress test. Absolutely no problem. I did have blood work, ekg, barium swallow, physical therapy, and a sleep study. I was diagnosed with mild sleep apnea. I asked the coordinator if the sleep apnea will deter the surgery date. She said the anesthesiologist will review the sleep apnea results and determine if further measures need to take place.

So my final stats and comorbidities are:

Ht: 4'11"
HW: 225.6 (BMI 45.6)
CW: 213.8 (BMI 43.1)
mild sleep apnea
high cholesterol
back pain
knee pain

I really wanted to post in the event someone in IL may have the same insurance and seeking answers. Although I highly recommend contacting your health insurance representative and obtain updated and accurate information for your concerns. Thank you for reading my rant. I wish you all success and infinite happiness throughout your journey.

Very best of luck on your journey :-)

Thank you very much Stacey03.

You're on your way! Congratulations! And yes, everyone has to watch their insurance!

Thank you AnnieG. I am excited and nervous, however, and making sure I am mentally and emotionally prepared for this journey.

You are lucky to have insurance, many of us didn't. All those hoops will be worth the money you will save. Best of luck to you!

Hi Sraebaer. I am truly blessed to have insurance whether state or through employment. I purposely scheduled a check-off list and attended each appointment, nutrition visit, diagnostic exam, physical therapy, and support group. I have a binder with every scheduled appointment, meal, exercise, referal, exam results, personal note and medications consumed that I carry with me to each visit including my PCP.

I was adamant about meeting the requirements for my previous insurance and not missing an appointment and I did not realize there may have been different requirements for the new insurance. I just wanted to keep everything well organized with complete and accurate updated information throughout the six months pre-op. I thank God for this blessing. I will prepare my post-op binder and supplies next week.

That is awesome! Looks like you will be getting a surgery date soon! Yay!!!
PS-I'm 4'11" too! :)

Christie 13 thank you. I love being 4'11". I can't wait to wear heels too. I haven't had on a pair of heels in about 10 years. Although I did wear platforms last summer and fell as soon as I took the first step off the porch. :o No, I haven't put platforms since that unfortunate tumble.

It's a shame to hear that.

Hello there! How are you coping?