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What is the 6month supervised weight loss.



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Ok, so I'm just getting started on the WLS journey. I haven't even seen my surgeon yet. I am fairly certain that my insurance will cover the sleeve surgery once I jump thru the hoops, but I was wondering if anyone can give me more details. I have Anthem Healthkeepers ( same as anthem BCBS I assume). And I have a BMI of 44.4, but no comorbidities at all. As far as the 6month supervised weight loss thing, how does that typically work? Am I just writing everything I eat and drink down and workouts? Do I check in with the Dr monthly? Just trying to get a handle on this whole thing. Thanks y'all!!

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Different insurance plans and practices require different hoops so everyone's answer will probably be different. My supervised diet consisted of 3 months of appointments at my doctor's office where I had my weight recorded and then met with a nutritionist for a 30 min group class. That was it but I have Cigna so different hoops [emoji4]


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My insurance requires 3 months, so that's 4 visits. Initial consult with surgeon counted as 1. Then I would have seen the nutritionist, taken a beginners class, and talked to the surgeon again. All with weigh in and talks about nutrition.

I think a recurring theme seems to be that you have to actually see the dr, weigh and talk about diet, exercise, etc, and have them include it all in their notes section. Some seem to use their Pcp and some use the Bariatric facility.

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I had Blue Cross/Blue Shield of Texas and wasn't required to undergo a supervised weight loss program during the pre-approval process.

My friend had a different BC/BS health plan and underwent the 6-month supervised weight loss visits. She was not required to lose weight; however, she had to have 6 documented visits with a physician, nurse practitioner or PA that recorded her weight.

She actually gained weight during the process. She pre-qualified for the sleeve at 218 pounds and ended up at 231 pounds a week before surgery. She lost 7 pounds on the pre-op diet and weighed 224 on surgery day.

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One more thing, I started with a bmi of 35.5 and was told I couldn't drop below 35. Stupid insurance rules.

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One more thing, I started with a bmi of 35.5 and was told I couldn't drop below 35. Stupid insurance rules.

Sent from my XT1254 using BariatricPal mobile app

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This is just another hoop to jump through for the insurance company. My surgeon's office supplied me with a form so ask and see if they have one. Go to your primary care doc and tell them you need to be on a medically supervised diet for before you qualify to have the surgery. See them monthly and take a copy of the form. During that time do try to get into the habit of something that you will have to do after your surgery such as walking 30 minutes a day, drinking 64 ounces of Water, chewing your food to liquid or even putting down your eating utensils between bites.

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I have BCBS FEP so my requirement is only 3 months but for me, really all it is is seeing either my surgeon or PCP once a month. Surgeon said not to see both in the same month or I'm paying a copay for a visit that doesn't count.


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