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I know some insurances don't cover DS. What insurance do you have that worked and required less than six months weight management ? What was the BMI requirement?

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I know this thread is more for DS, but I wanted to chime in.

I have Cigna and have the band. For the weight loss surgeries (at the time I was only considering the sleeve or band but if I remember they didn't specify different requirements for different surgeries.

Anyways - the requirements for my Cigna was

*35 BMI with at least 1 comorbid condition - high cholesterol, sleep apnea, high blood pressure, etc

*40 BMI no other requirements

I was required to follow a 3 month physician supervised diet as well. No WW.

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I'm not sure if that's a Cigna generic policy or if that's just what my employer has negotiated in the 'package'. Do you currently have insurance or are you using this to shop around? Some people seem to be doing ok in NY on other posts with the new Affordable Care Act. I really do not know any details of that though.

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I am in the same boat; looking for the best insurance policy in NY with less weight management time in 2014 (because a lot of insurance policies changed their fine print). I'm interested in the LapBand. Any information would be appreciated.

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Oxford.

  1. 35 BMI with comorbidities;
  2. 40 BMI.

No supervised diet plan. This was in 2005, though. Don't know if it's changed since then.

Edited by Postop

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Apparently Oxford now requires a supervised diet plan for 2014.

I really don't want to wait 6 months; I know it's easy to make excuses about timing but 6 months doesn't work very well for me. This is the only time of year business is really slow (just finished the 2013 holiday season) and I need to take advantage now.

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I have BCBShield in NYC and got vsg done with all requirements in 3 months

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I got approved by Cigna for the DS.

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I have Blue Cross Blue Shield of IL (even though I live in Louisiana) they cover weight loss surgery but I'm not sure about DS specifically, but their requirements are:

BMI over 40 or BMI of 35 w/ 2 weight loss illnesses

Over 18yrs old

1 visit w/ nutritionist

1 psych eval

No supervised diets!

I had my consult, psych eval and nut visit all in February and now I'm just waiting on insurance approval for VSG.

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Turns out my insurance didn't require it, and they just go with whatever the doctor wants. Which is why I decided to switch to another surgeon, as I didn't see the need to do another six months (I had WLS two years ago.) So I might be able to get my surgery sooner than I thought.

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