Hello,

Does anyone know if BCBS requires 6 months or 180 days of monitoring before surgery?

TIA

~Sandy~

I varies from state to state, I believe. However, in Wyoming they require six months of monitored dieting. Additionally you must prove that you have been obese (with documentation for 5 years).

For NC it's a little different if they do it as inpatient you have the 6 visits with NUT and need an authorization. Outpatient you don't have to do all the visits nor will a authorization be needed

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Bcbs of illinois does not require any dieting. Best of luck!

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@@mommabear2311 It not only depends on the State but often on your particular BCBS plan and patient circumstances. You need to find out the requirements specific to you and have the surgeon's office confirm them (I was given wrong information by BCBS Rep).

You should also be able to go to your insurance plan main page and under medical policy of you don't know the code type in weight loss and it will show you all requirements . I hope this helps

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Edited August 25, 201610 yr by Monet08

I went to look at my main page and med pol and it shows no requirements I'm going to call BC/bs and ask where they see the six month requirement to visit pcp or nutrionist

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I actually found the right page and it doesn't give me access darn it lol I'll call and ask them to send me them. I'm so impatient

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Bcbs in Kentucky requires 6 months

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6 months medically supervised diet for Anthem BCBS of va

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I'm pretty sure it differs between the plans within BCBS. I have BCBS in New Jersey and it took me a little more than three months to complete all the pre-cert requirements. The Doctor told me it could take anywhere from 5 - 15 business days at that point for Horizon to make a decision, but it only took them five days. So It moved along pretty fast for me. It's just a matter of getting all of your pre-cert work done, showing your committed to the process, and doing what needs to be done.

Good luck!

BCBS MN required 6 months of supervised diet by PC doctor or dietician. I just got my approval today. It took 8 business days for approval. They told me it could take up to 10 business days for approval. Now I'm just waiting on a surgery date.

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Highmark BCBS in PA requires 6 months

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My bcbs in NC did not require any supervised diet.. It did require I meet with nurtrionist but no required number of appts.

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Thanks so much everyone! Sept 7 will make my 6 months. I'm looking forward to surgery!

~Sandy~

Well here's an update.... I called my insurance because I found several things on line about coverage and it was all different then what I have been told at the weight loss center even. I have BCBS of Michigan. The representative said that the monitoring period is 6 months unless your BMI is more than 50 then the 6 months of monitoring is waived. Mine is 55.4. This is the one time that being super morbidly obese has been good for me! I really need to start this weight loss journey. I am having a lot of health issues and am looking forward to every minute of becoming healthier!

~Sandy~