Hello from east TN - insurance requirements

excarolinagirl · September 7, 2008

Hello,

I am 47 yrs old, weigh 240 pounds, am scheduled to meet with bariatric surgeon on Fri. I haven't started my 6-month weight loss program (required by my insurance BCBS/TN - also requires 10% weight loss prior to surgery).

Would enjoy hearing from others who have gone through a similar process (have to lose certain percent of weight before surgery).

Dee

*slim* · September 7, 2008

Hi. Welcome to the forum! I am also in East TN. I haven't been banded yet, but I have gone through the insurance hoops. I have BCBS of IL. They required a six month diet plan, but it just had to have been in the last 2 years. I had a six month period during 2006 that I had gone to the doctor every month. My doctor used the information from those visits as my supervised visits. With that, it only took me about 2 months from start to finish (that includes the month it took to get in to see my surgeon). I am just waiting for my surgery day now and getting more nervous every day!

Good luck to you on your journey to a healthier you!

Edited September 7, 2008 by *slim*
correct spelling

The Fireman · September 7, 2008

I also have BCBS of TN through my employer (a large company in Kingsport)and was required to have the 6 mo. weight loss program with my PCP,but was not required to have the 10% weight loss.In my case that would have been 32 pounds.If I could lose that much I would not have needed the surgery.I was banded in Jan.2008 and have lost 62 pounds and feel good.have 6.5cc in a 14 cc band and getting very close to where I need to be with my restriction.Good luck with your weight loss plans.

MKelder · September 7, 2008

Hello I am going through the same as you. I have to lose 10% prior to the operation. a total of 23 lbs. I really cut back on my carbs and sugar. I am in my 2nd week and I have lost 6lbs and 1 inch all over. I have not started to exercise. But this week I plan to do at least 1/2 hour everyday. I live in upstate NY. Good luck to you.

excarolinagirl · September 7, 2008

To the Fireman: I work for Eastman Chemical Company. Is that your employer? If so, I will check with my PCP about the 10% weight loss. I figure if I could lose 24 pounds, I wouldn't need the lapband surgery.

*slim* · September 7, 2008

To the Fireman: I work for Eastman Chemical Company. Is that your employer? If so, I will check with my PCP about the 10% weight loss. I figure if I could lose 24 pounds, I wouldn't need the lapband surgery.

I didn't lose 10% even though that was in my file. You don't really want to lose as much as they say. If you do, they could come back and say that you don't need surgery because you can do it on your own. Even my surgeons insurance staff told me not to try too hard. Just my own experience.

The Fireman · September 9, 2008

To the Fireman: I work for Eastman Chemical Company. Is that your employer? If so, I will check with my PCP about the 10% weight loss. I figure if I could lose 24 pounds, I wouldn't need the lapband surgery.

Yes,but im in Texas