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will insurance cover me without....

I have BC BS and it is a really good policy, it covers weightloss surgery with only a few requirements.

1) BMI of >40 or 35 with co-morbids

2) failed weightloss attempts (DUH!!)

3) psysc eval

4) supervised weightloss (6 months accumlative in last 2 years)

My question is this, my pcp has very few records of my weightloss attempts. She has put me on several lowfat, low cal, low cholestrol, low everything diets. But there are only records of 2 such diets in my chart. There are several cholestrol checks in the last 18 months but nothing else, she has one visit listed as reccomend diet/exercise and nothing else charted at all. They just called me and said that they were going to list a "late chart entry" that says that they gave me a low fat low cholestrol diet in dec of 2003.

Do you think I am going to be denied over this? I have every other requirement met, physc eval is set-up. I need to lose 95lbs and I have a BMI of 38.7 with several other weight related problems. Thanks for the info~Mandy

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Mandy, we can't predict what your insurance carrier will say. But I will say that even if they say no on that basis, you're only six months away from a YES. Start right now and go to your PCP and have them put you on a plan and make notes monthly about your progress. Before you know it, you'll be done!

Mandy ~ GOOD LUCK ON STARTING YOUR PROCESS FOR YOUR BAND. Like others said you won't know till you try. I also have BCBS and they approved me two weeks after receiving everything on your list. So if all you are lacking is that Documented diet then do like Alex suggested get on it for 6 months and get that band!! Let us know how things go!

Mandy your lucky, my bcbs policy wants 12 consecutive months of supervised weight loss attempts. My husband and I are lucky we have gone to our DR for 15 years and he has been with us for many, many attempts of weight loss. But I find bcbs being ridiculus with the 12 consecutive months. You would think they would jump at the weight loss surgery considering how much money they will save on all the other things they wont be paying for any more, insulin, strokes, heart attacks, knee and joint surgery etc.

  • 4 weeks later...

MANDY;

I HAD THE SAME ? I HAVE CIGNA. I CALLED THEM ASKED THEM WHAT THE QUALIFICations are they didnt say anything about the 6 mo diet documention but the lady that held the seminar did that i went to said cigna reqires it i have my 1st app. april 12 i hope my policy doesnt habe that limitaion good luck

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