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Waiving the 6 month requirement?

Hey everyone! I have a quick question. Will an insurance company that requires the 6 month wait waive said wait if the patient's bmi is over 50? I ask because I've seen some people say that it's true and I'm wondering if this has happened to anyone.

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Hey everyone! I have a quick question. Will an insurance company that requires the 6 month wait waive said wait if the patient's bmi is over 50? I ask because I've seen some people say that it's true and I'm wondering if this has happened to anyone.

I haven't heard of it happening

  • Author

OK thank you for your response!

@@Joyecamp1992 Hi. I just wanted to add that I haven't heard of it being waived.....but it's not just a "wait" period. It's time for education and learning a new way of living......This is not a surgery that anyone should just decide to have one day and be able to schedule it the next. It's huge and you really have to use this time to educate yourself so when the time comes you can be successful and know what to expect.

I will also add that 6 months is not the "standard" some plans have a 3 month supervised weight loss program requirement and others don't have this requirement at all.....My insurance is one that doesn't have the supervised weight loss requirement, but there are still other requirements around education and testing and by the time I get all those done it will end up being somewhere close to 3 months from the time I started to when I finally get my surgery.

I am ending the near of my three month supervised weight management next week. I just finished the other requirements 2 weeks ago... I have been happy for the time to have the mental preparation and to understand the reality of the weight loss surgery. Additionally, I lost weight which will reduce my risk and due to exercise it should help my recovery.... Look at the time as a positive opportunity not a negative restriction. Use it to practice getting water, eating slower and eating without drinking. My BMI was 51 when I started... I am now between 46 to 47 BMI

I have BCBS of florida a PPO plan though my husband's work.@@bellabeans

I also have Blue Cross Blue Shield PPO and my BMI is 54 and I still had to go through with all six months. Like others have said it's more than just a wait. It's a time to learn everything you can about post op and how to be the most successful with your new tool. I just finished my six months on April 1 and I feel fully prepared and confident but I will be successful after my surgery.

Sent from my iPhone using the BariatricPal App

@@Joyecamp1992 Hi. I just wanted to add that I haven't heard of it being waived.....but it's not just a "wait" period. It's time for education and learning a new way of living......This is not a surgery that anyone should just decide to have one day and be able to schedule it the next. It's huge and you really have to use this time to educate yourself so when the time comes you can be successful and know what to expect.

I agree - there is actually quite a lot to take in about what you will need to do and what you can expect, both in terms of problems in the early going, what do do to minimize them, and what to expect in terms of progression... and then there are the significant lifestyle changes that you need to incorporate in diet and exercise. This is definitely a big deal, it's not automatic and it's not easy. Not saying it's not all worth it in the end, far from that, but you need to educate yourself and to develop new habits, and that takes time.

I am ending the near of my three month supervised weight management next week. I just finished the other requirements 2 weeks ago... I have been happy for the time to have the mental preparation and to understand the reality of the weight loss surgery. Additionally, I lost weight which will reduce my risk and due to exercise it should help my recovery.... Look at the time as a positive opportunity not a negative restriction. Use it to practice getting water, eating slower and eating without drinking. My BMI was 51 when I started... I am now between 46 to 47 BMI

that is awesome!!!..

  • Author

Thanks everyone for taking time to respond! Yes, I know that the six months is a time for us to learn about living healthy after surgery. I wasn't downplaying that at all. I was just curious because I was reading a few posts on here and on another website and some people were mentioning their six months being waived for whatever reason.

Alot of BCBS plans revised the requirements for the surgery in March of 2015. I have BCBS of MA and they do not require 6 months supervised anymore. However, you still have to do the psych eval and a nutrition eval.

When I first started the WLS journey, the insurance I had also had a 6 month wait.

At the end of my 5th month, I switched insurance companies & was good to go because this one had only a 3 month wait.

Looking back I wouldn't change a thing. I learned so much during those 5 months of pre-op education. I was well prepared, confident in my decision and understood my part I had to carry out post op. Don't rush things, the wait period is for us to learn & understand what we are doing.

The wait period will fly by and your surgery date will be here before you know it. [emoji4]

I have BCBS of Michigan and they waived the 6 month waiting period since I had a BMI over 50. Super quick process for me...first meeting with the surgeon office was March 17 and having my sleeve April 27.

Sent from my iPhone using the BariatricPal App

This is good to hear. I have BCBS of Michigan and have a BMI over 50. My first appointment is April 25th. They made it sound like I would be on the table in 4 to 6 weeks.

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