Good Morning everyone! I am 5'5" and 243lbs. That puts me right at a 40.4 BMI. From what I understand my BCBS of GA requires that I participate in a non-surgical weight reduction regimen for at least 6 continuous months. During that time BCBS requires of the 6 month program as follows:

The clinical record includes:

• A description of “what” the individual actually did in the program, that is, did they follow the diet and exercise recommendations as an active participant for six continuous months in the two years prior to surgery?

• A record of the individual’s weight at the time of each preop visit, and the amount of weight loss achieved each month of the documented 6 month period

• A description of the actions taken by the surgeon and nutrition team, prior to surgery, to encourage the individual’s compliance and address any individual obstacles to positive behavioral changes

Ok. Have any of you experienced that in this 6 months weight loss program that your BMI dropped below the requirement of 40 resulting in denial of coverage for the procedure? At this time, because I don't know if PCOS and untreated borderline high cholesterol counts as co-morbidities, I want to see if the drop below 40 will derail my efforts. Thanks you all for any help in advance!!!!

And a double Whoooee for that!

Afternoon All! For anyone who is curious I had my appointment with the surgeon and the insurance specialist today. The insurance requires that I attend 6 months consecutive visits with a dietician. I was told that if a month is missed, I will have to start over. Insurance requires that I have that consultation with a psych. The doctor's office requires more - that I attend a surgery seminar, join a WLS support group (in person or online), have an upper GI, and a sleep study. I'm excited to start the journey! My first visit doesn't count as the dietician visit, but that will be later this month.

Now, the insurance question I had as it relates to my BMI. I ended up having a co-morbidity that will put me in the range to have a 35 or 40 BMI. Because of this, as long as I stay above 35 I will be ok per my Surgeon. If I fall below 35 before the 6 months, I will not be approved, even if my first BMI measurement was at 41.5. I don't even know if I can lose that much weight before April/May but I do want to try to get my habits surgery ready.