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Blue Shield California

The current written requirements for Blue Shield California state 6 month supervised diet is required. I printed the policy in mid-April. Since then, they have added a preview of their Bariatric Surgery Policies that goes into effect June 30, 2015 that seems to imply that the length of time required for the supervised diet is to be determined by the individual doctor and patient circumstances. Does anyone know if the requirement for supervised diet is really changing on 6/30/15? I plan to call Blue Shield on Tuesday to see if anyone can tell me, but my prior attempts at getting phone info haven't been great. I'd be thrilled if I can get approved before the end of the 6 months, but I'd also need to speed up saving money. I think my copay is going to be about $4500.

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In North carolina bcbs changed the 6 month diet supervision a few years ago. Hopefully in California they do the same, lucky for you and plenty others copay is not that much. I'm looking to pay $7000 or more for gastric bypass. I have been thinking about the surgery for years but I'm terrified of needles for blood work and the knife that will be used for the incisions :(

  • Author

Blue Shield California did confirm that if I submit for approval after June 30th, they won't require the 6 month supervised diet. I have a 20% copay, so I will end up paying my maximum out of pocket of $6250 by the time I'm done with all of the pre-surgery requirements and surgery. It's still worth it. I'm counting the days.

  • 3 weeks later...
  • Author

Blue Shield of California really did eliminate all requirements for medically supervised diet. I got approved the first time I submitted. My surgery date is July 9th. This is much better than the late October date I expected.

@@cusoon how did you get a surger date before the June 30th change in criteria? My Dr is waiting until tomorrow to even submit.

  • Author

My surgeon submitted early and they approved early. In California, they just don't care about the supervised diet any more. Yippee!

Well I would have mine submitted a day early, but apparently my psychiatrist hasn't sent my evaluation yet. Aggravating!

My surgeon submitted early and they approved early. In California, they just don't care about the supervised diet any more. Yippee!

how many days did it take to get approval?

  • Author

Submitted on Friday afternoon. They approved on Wednesday. I called Blue Shield directly to find out about the approval. I was too anxious to wait for written confirmation or my surgeon's office to call me.

Awesome!

  • Author

I was surprised at how easy it was to deal with the Blue Shield reps. They were super nice about me calling daily to check the status.

My paperwork should be ready tomorrow

  • Author

Good luck. I hope they approve it quickly.

  • 1 month later...

I wonder if that is the same for Anthem Blue Cross. I have to do six months and the time is going by so slow.

  • Author

It's worth a telephone call to your insurance company. I tried to look for a policy update for Anthem online and couldn't find anything newer than January. The January policy requires 6 months.

  • 2 weeks later...

Anyone have to have 5 years consecutive medically diagnosed o morbid obesity?? I have anthem bc/bs and my policy now says nothing about the 6 months but the 5 years which I don't have as I've only had insurance since march1st...am self employed and could never afford it prior

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