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BCBS ALABAMA

I am currently in the 6 month process of physician led weight loss program, when I went to my weight loss seminar I was told by my doctor that if I lost more than 30 pounds that I could possibly be denied by my insurance. My ob/gyn is doing my weight loss management and she prescribed me phentermine and Glucophage. I know that I can lose weight taking these medications I have in the past but as always I pack the pounds back on and then some. I am scared that if I lose more than 30 pounds that insurance will deny me and I will be back at square one. I was wondering if anyone else with BCBS AL has had this issue and could share your own experience with this. I have PCOS so I am insulin resistant and I also have my medical record proving that I have struggled with my weight for the past five years.

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Hey..

I have BCBS of al and Im currently in my 6 month doctor supervised weight loss program. I'm fixing to start month 5 out of 6 in two days so I'm nearing the end! I'm not sure what your bmi is, but you have to be above a 40 with no co morbidity's and 35-39 with co morbidity's.. If you dip below the 40 and don't have a co morbidity then they will not approve you. Also, I have PCOS as well and my particular bcbs of al does NOT count that as a co morbidity. If you have any questions or need to talk feel free to message me or email me anytime. :)

  • 3 weeks later...

I'm so happy to see this post, I just posted something similar because my primary said to be careful not to actually lose weight when he started me on my plan. I have BCBS of al too and have called my surgeons office but haven't heard back. Now I'm scared to even lose a pound but what if they need to see weight loss! This is all so insane to me, where did you get the 30lbs. rule? From your doctor or BCBS? I'm just about at a 43 BMI.

  • Author

I'm so happy to see this post, I just posted something similar because my primary said to be careful not to actually lose weight when he started me on my plan. I have BCBS of al too and have called my surgeons office but haven't heard back. Now I'm scared to even lose a pound but what if they need to see weight loss! This is all so insane to me, where did you get the 30lbs. rule? From your doctor or BCBS? I'm just about at a 43 BMI.

My surgeon is the one who told me that if I lost 30 pounds in the pre op diet that I wouldn't qualify for the surgery more than likely. If I do I will be below 40 BMI, so my plan is to continue on with the weight program and try to only lose 20-25 pounds during the program. I feel as though surgery is my last option to finally lose the excess weight, I know it is not going to be effective unless I am fully committed to this new lifestyle.

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