Not sure if anyone on here has bcbsil HMO that can answer this - but the medical policy has THIS tucked into it toward the end, and I'm wondering if anyone else also interprets this to mean that there is no longer a requirement for medically supervised diet?

2011 Update

Patient Selection Criteria for Coverage

A requirement that a candidate for bariatric surgery complete a formal, medically supervised weight loss programs of specified duration has been a fixture of HCSC bariatric surgery medical policy for some time. The rationale for this requirement was founded on review and interpretation of available evidence in the scientific medical literature, primarily national consensus guidelines. However, HCSC has decided to modify this requirement based on a current review of the bariatric surgery scientific literature related to required pre-surgery weight loss programs, and including consideration of input from bariatric surgeons and their professional societies. The HCSC policy will no longer require documentation that a morbidly obese member must have completed a pre-surgery weight loss program of specified duration as one of the criteria for benefit coverage of bariatric surgery. This change does not mean, however, that HCSC no longer believes that successful bariatric surgery requires multi-disciplinary support from the member's bariatric surgery program and a life-long commitment to life-style changes.

Anybody know about this? I called them today and the girl I talked to was clueless - she referred me to talk to my PCP and I already have an appointment with him for Monday. Any help would be appreciated

I agree it's a pain, but I'm willing to beg at this point!! Hopefully it won't be too awful to get this done. I'm so frustrated not having any direction. I can't find anything on the whole world wide web about anyone having wls thru bcbsil h.m.o. how is that even possible! Lol

Ill keep everyone updated!

I agree it's a pain' date=' but I'm willing to beg at this point!! Hopefully it won't be too awful to get this done. I'm so frustrated not having any direction. I can't find anything on the whole world wide web about anyone having wls thru bcbsil h.m.o. how is that even possible! Lol

Ill keep everyone updated![/quote']

I head an insurance just last month called beechstreet ppo / embs employee management services ... No one on the plant has heard of it ... But the company I work for change there ppo to aetna

I have my first consultation on aug 2 at lifeweigh bariatrics I have a *** bcbs can anybody tell me what are the next step after the consultation and what to expect from bcbsil ***

I would try the insurance company again. The hospitals don't always know and there are sooo many insurance companies. I was told I had to resubmit everything because I changed docs/hospitals. The insurance company told me it wasn't necessary, but the hospital did...So although it wasn't necessary, the hospital would not go forward without the additional approval letter, which I did get last week. So, hopefully, the scheduler will be calling me soon and get me a date.

SO TOMORROW IS THE BIG DAY 1ST STEP TOWARDS A NEW ME SO NERVOUS ....1st CONSULTATION. ....ANY ADVICE IS WELCOMED....PLEASE ANXIETY IS THE WORST

My doctor told me that this was changed because people were dying during the waiting period.

Hi I'm currently in process of supervised diet and they been playing games with saying it is up to my surgeon how long it would be then the diet supervised girl is like you have 12 months of this when I just got done doing a year of calorie counting by myself, I pay 300 a month for this insurance just for the wls and I called bcbs and they act clueless to it all even talking to the bariatic people of bcbs I told the girl at the Kane a Center in Hoffman estates that it was bs when I just got off from a over a year of trying myself to just be told oh well do it again for another year.. I pay 300 a month for this bs and I can't even get anything I need done.. If anyone has any advice or insite all is welcomed

Hi I'm currently in process of supervised diet and they been playing games with saying it is up to my surgeon how long it would be then the diet supervised girl is like you have 12 months of this when I just got done doing a year of calorie counting by myself, I pay 300 a month for this insurance just for the wls and I called bcbs and they act clueless to it all even talking to the bariatic people of bcbs I told the girl at the Kane a Center in Hoffman estates that it was bs when I just got off from a over a year of trying myself to just be told oh well do it again for another year.. I pay 300 a month for this bs and I can't even get anything I need done.. If anyone has any advice or insite all is welcomed

Hi NikkiB1, I'm just starting out the process of getting WLS through Kane Center. I also keep hearing about the one year supervised diet, which makes no sense to me since I've already done it with my previous PCP. I recently switched to BCBSIL HMO and had to have medical records forwarded to the Kane Center. I'm really hoping they accept that and don't make me go through another year of supervised diet. Are they still making you continue the supervised diet? What else are they are requiring for WLS?

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They are having me do a lot more then what a ppo person would need to do, open enrollment is November 1st so I'm going to switch to ppo so I don't have to go through till next May and also will cut down on what I need to get it done, it is really just crazy how much they want from you I mean come on.

They are having me do a lot more then what a ppo person would need to do, open enrollment is November 1st so I'm going to switch to ppo so I don't have to go through till next May and also will cut down on what I need to get it done, it is really just crazy how much they want from you I mean come on.

That's crazy. I just don't understand why they make us jump through hoops for this when it is a medical necessity. I wish I had switched to ppo instead of hmo. I previously had united health care ppo, but they didn't cover WLS. Good luck on your journey. Who is your surgeon? I have my consultation on Friday with Dr. Guske. I'll see what they tell me. *crosses fingers*

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Guske is mine.