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Health Alliance

I was told by Health Alliance I had to do a 6 month pre-op diet but then found out I would need to have co-mobitities since I am only at a 38.4 BMI.

I then read the policy and said that I had to have done a six month Dr supervised diet within the last 3 years so I asked the Dr for my records and it does show that I was at 255 lbs back in oct 95 and I did do a diet with him for longer than 6 months , so my question is..........do you think they will use my BMI at that starting point? They do not require co-morbids with BMI over 40 and am hoping they will use those numbers. What does anybody out there think?:drool:

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From my understanding, your start BMI, if you don't have the required number of co-morbs (ex: some require 3) must be 40 or above and stay above 40 the entire time. If you do have the required number, as long as the BMI is above the minimum (usually 35) you're fine. My guess is if you don't have more than the required, you will be denied based on the fact that you are below 40 on the BMI now.

  • 1 month later...

My doctor has a running total of my weight for the last 10 years and I have been going to weight watcher for the last 2. I am hoping I can skip the I can change program. I am at 35.8, but for the weight in tomorrow I am not taking off my shoes, wearing very heavy pants and eating pancakes for Breakfast. Anything to make me heavier, so I will lose the 5% faster. They look at the BMI at the start not what you are at the end of the 6 months according to the information I received.

Cyndi

I have heard people say that they where ankle weights under long jeans for weigh in and it has actually worked for them.

The doctor approved me is 3 seconds. The paper is sent to Health Alliance so what I am hoping is I can used my last 6 months at weight watchers for my goal.

That is good news! Good luck with the insurance and keep us posted.

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