If You Have A 6 Month Waiting Requirement For Lap Band, Here's How I Handled It...

[PalmBayTish72 4]

When i went to have surgery in Feburary of 2010, I was expecting to be self pay, but it turns out BCBS of Florida with my plan in particular covered the lap Band. Awesome!

But they required a 6 month waiting period. Crap!

When I first submitted all my information to the insurance company in January of 2010, I also included photo copies of my weekly weight watchers weigh in's theat showed a 6 month history of trying to lose weight. I also contacted my General Practitioners office and have them send my entire medical fil to my Lap band surgeon, so they could go through and pull out all the info from my file that dealt with my weight (the different medications i tried, etc) and included that, so they would see I had a history and had been consistently trying to lose weight, only to gain it back.

They (Riverside Surgical) submitted the whole package, along with my recommendation from my surgeon, the psychatrist, etc. to BCBS of Florida and i was approved within a few days....WITHOUT HAVING TO WAIT 6 MONTHS. I had my surgery 3 weeks later.

My whole point is don't give up...it is possible. You just need to have all your stuff together and a little bit of prayer helps too!

[Cindy C 150]

I think some people are under the misconception that the 6 month diet has to begin AFTER the process begins. It doesn't. You just have to prove that you have attempted to lose weight on your own. I had BCBS of Michigan. My primary wrote his letter to the insurance company telling them that I had met that requirement and I was approved immediately. In fact, I went to him on a Monday and already had a surgery date for the following Tuesday. He faxed the papers to the insurance company and I got a call from the surgeons office on Thursday that the approval came through.

[Grider 92]

I have Fepblu and 2010 to 2011 rules have changed, so it best to call your ins co's and see where you are, with your surgeon.

[MrsMoretti 0]

well maybe i have hope just got submitted today but tricare i guess just changed there policy stating that u need medically documented attempts for weight loss but it doesnt state that there has to be 6 months.... anyone know about this..?

[Christine Shays-Anderson 0]

I have a 6 month insurance wait for the band. They did not tell me that it had to be six in a row.Had they stressed that I would not have let my anxiety get in the way and would not have missed my Nov appt. So instead of getting the surgery next month, I think I am back to square 1 and its now only my 2nd appt!

Oh well, I guess. I already know I am my own worst enemy when it comes to weight loss. So what did I do this month to try and lose weight? Nothing!! I was a bit depressed when I found this out.

[xavier 153]

I dont mean to sound mean but you can get blocked from this site for having advertisement on you posts...one person who hits the 'report' button can do it! I have seen others have that happen.

[Doodledo73 7]

Hi. I am just starting my journey. I have had my first consultation with the surgeon and he was so nice!! I met with the insurance person for the office and we went over what my insurance covers. This is where I was informed of the 6 month supervised diet. I sort of was expecting that after reading so many posts about it being a requirement. However, I was told it had to be six consecutive months. I have read and re-read my policy and it doesn't specify consecutive months. It just says six months of supervised diet. In the past year I have been to see my doctor at least once a month for 8 months for my weight. The only thing is there were not six in a row. Is there anything else I can do?

[lika92012 9]

i was told today it should be 6 consecutive month or 2 periods of 3 month each in a year(like January, February,March and may june july)

[Christine Shays-Anderson 0]

Well good news is that they approved me with only having to have 6 months total. Date is set for 30th of March! Wow so much to do before that date. I just found out on Tuesday.

[☠carolinagirl☠ 18,721]

congrats christine. i am working on month 3 of my 6 in a row all the best

[Michelle Wolverton Bates 0]

Wow this gives me hope.... I have 6 detailed months from a certified personal trainer who I worked with 2-3 x per week. I'm going to try and use this instead of the physician sign off. The CPT did more for me than a DR is going to do. I hope My ins accepts this.