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Who determines if you have to go on a pre-surgery supervised weight loss program?

The surgeon or the insurance company? I called BCBSNC to see if I was covered. I was told under our plan it was if deemed medically neccessary (minus the $1,000 family deductible) (we have PPO-Blue Options 123). I then asked who determines if you have to go through a supervised diet before being approved. The BCBS rep told me that was up to the doctor, if he said I needed a 2 month or whatever prediet first, that BCBS would pay for it if the doctor deemed it was neccessary.

It just seems on here that I read it that when people say they have to diet for 6-12 months first before approval that it is the insurance company making them jump through this hoop. Anyone have any input?

Thanks in advance!

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Insurance requirements. Some sugeons may require patients to lose X lbs or X% of weight before they will do the procedure, but medically supervised diets are in the realm of the insurance companies.

Most of the time, anyway. I would imagine there could be an exception out there somewhere.

From what my doc said it's typically the insurance co. (Mine did) but.. at my doc's office the have people go through a 4-5 week "pre-op nutrition" program. Which the person in charge of that said I may be able to have waived since I went through 6 mos that my insurance required. So I guess my answer is it just depends on what your doc & insurace decide.

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