Hello Everyone--

I am in month five of the six-month medically-supervised program required by my insurance company (Blue Care Network) before I can apply for approval. I must admit that I didn't find the program very supportive or useful and have managed to gain two pounds.

For those of you who have completed this phase of the process, how did you do? Will the fact that I wasn't able to lose any weight impede my ability to get approval? I notice that a lot of people post that they did lose some weight prior to the surgery. Was this from the medically-supervised diet or from the pre-op liquid diet?

I feel a bit down about failing on yet another diet and actually had a very stressful encounter with the dietitian today. Overall, it's been a bad experience on top of not losing anything.

Hello Beautylocs:

I have BC/BS Net Value with Hills Physicians, which required that I complete 6-months supervised diet and a pysch eval prior to approving me to see the surgeon. I started out at 251 in January 2008, which is when I started the supervised diet. I yo-yo-ed up and down, but never went over the original 251. (My BMI was 24.2).

Anyway, in August 2008, I finished the required 6-months at 246 pounds. All paper work was submitted and approval was granted two days later.

Right now I am waiting for my test results for the upper GI and the H-pylori tests. Once we have those, we send everything into the insurance for approval...At least I hope approval.

Today I am at 240 with a BMI OF 40.1 Every insurance is different. Good luck with your journey.

Edited October 16, 200817 yr by TQUAD64
oops BMI was 42.2

Thanks, Tquad64. My psych eval is scheduled for next month, which is also when I'll attend a required support group meeting. I'm hopeful that I'll have a surgery date by the first of the year.

I do want to lose at least 15 pounds prior to my surgery and actually rejoined Jenny Craig. Perhaps with that, I'll post a loss on the medically-supervised program, which would make me feel a little less like a failure.

Congratulations on coming this far! I hope you get your surgery date very soon.

Take good care.

I also had a similar experience. I have BC/BS and I started this process back in February at 253. Per the insurance I went through the 6 month process ans lost about 10 pounds. During the 5th month (Sept 5th) I was laid off from my job and I lost all hope for the surgery. I told my dietitian and she encouraged that I still go to the 6 month appt which was 9/24. I went and by that time I gained some weight. I guess I was eating for emotional reasons; anyway, they re- submitted my insurance on the 25th. They called everyday and one day they called and the insurance company knew of the stop date. We thought for sure they were just going to lag out the approval. I had no hope but I prayed, and the praying did me some good. I got an approval from bc/bs on 9/30 and my surgery is scheduled for 10/21. The moral of the story is don't loose hope and faith. Things will work out, even if there are bumps in the road!!

BTW, how do you get a profile pic to show up? I uploaded a pick and checked "use as default pic" and it still doesn't show. thanks,

i just finished my 90day diet with my family doc which was a joke in itself i didnt lose any i gained like 2 lbs doing so but he said himself you normally do when your more active and all muscle weighs more but anyways i finished it on oct 3ed and by monday the 13th i had an answer from aetna pos i was approved yeahhhhhhhhh iam excited but now things are moving so fast its crazy i start my liq 10 diet friday the 17th so i have like 24 hrs to go and iam scared and excited both iam not sure what all to drink but i know theres not much you can i was given the paper and its not much on it .but i also have know a lady from work who did this and lost 85 lbs and feels wondeful and says it was the very best gift she gave herself ..iam holding onto that thought for myself as well ...but nx wk i have mon upper gi and tue my last seminar wed more tests and meet with a doc about my meds being liq or crushed to take and then thur the final day to see my surgeon before surg monday the 27th so its been rather crazy here just thinking about it ,,,any words of advice on the 10 day liq diet would be great .good luck on your journey with your diet don't get excited over gaining the 2 lbs i guess its normal and normal is good .hang in there :thumbup:

This makes me feel good that I was not the only person who did not lose on the 6 month supervised diet. Well Actually I did lose a few pounds and then by my last month I had gained to be the exact weight I had started. I am embarrassed and wondering what the Bariatric Doctor must think, "Does she really want to lose weight." So they submitted to my insurance last week and I am waiting approval. My fingers are crossed....

I started this journey back in January, had my first visit with the surgeons office April 23 and was told Anthem BCBS required 6-month supervised diet. I was not a happy camper. The NP told me that insurance companies just want to see you've tried a medically supervised diet and it really didn't matter if I lost any weight. I visited with my PCP for 6 months. At each visit I was weighed and discussed my caloric intake, food choices and exercise regime for the month. My weight flucated a few pounds over the six months and I had gained 2 pounds at my last weigh in but I was approved. Its been a long road and I'm thrilled the game is over.

I started looking into this October of 07. Was going to do it then I got Kaiser Insurance. I asked them what they required and was informed that they do not cover any kind of Weight Loss Surgery here in GA. I was :cursing: to say the least. However the wait did me good I think. I went ahead and started the 6 month medically supervised diet that BCBS will require next year in August. That will be up in Feb. I went to the Dr's orientation at the end of Sept and when open enrollment comes next month i'm going to make sure I pick ins that covers this. I have been told by my Bariatric surgeons office that I can start everything else in January (6 month up in Feb) and realistically can have surgery by March or April. I'm excited. So far I have lost 12 lbs by cutting out soda's (down to 1 can of pepsi a day from 2 large cups) and just cutting down the amount of food I eat.

I am just starting. I want this so bad. My Docter called today and said my blood test came back and my thyroid is not working so he put me on Levothyroxin. He is supposed to make me an appointment with a dietition. He said I have to have a medically supervised diet for 3 moths before they will do anything else. It seems like it will take forever. What will happen if I lose weight will I be covered? or what if I don't? I am so worried. I need this so bad.

:sad_smile:kool all i done was went to my family doc and told him what iam doing and he had me come back once a mo. ad told me to reduce my fat intake and all the carbs and walk alot and i seen him once a mo for 3mos and the ins co approved me after ,my doc sent in the paper work to the ins co i have aetna pos and with in 10 days i had an answer from them .it was real easy for me .right now iam on the 10 day liq diet before surgery monday the 27th so its going good ..hope it continues .,good luck to you and keep on them ..the 90 days goes by pretty fast some have to do 6mos...so we got lucky there ...good luck:thumbup:

Hello All- Very upsetting news- I was denied again by bcbsil after an appeal was submitted by obesity law. I am very upset, very frustrated and I feel that I'm not being the best person I can be knowing this news. I still have 3 months left on my 6 month dr. supervised diet. Once I complete this do they have to accept me if I've met all the other criteris?

jennifer71

I would continue on with your diet and have that ready and don't give in to them keep trying this is what they want you to do just give up ....don't give up on yourself now....good luck to you

Hi Jennifer71--

I don't finish my six month program until November, so I haven't submitted my information to the insurance company yet. I can say that the six months went pretty quickly. Your three remaining months will hopefully be the same for you. In talking with people that have been approved, it does seem to be a bit different for everybody.

I've been advised to work closely with my surgeon's office and to be triple sure that I've met all the requirements. Like I said, I haven't submitted yet, but I have secured letters of support from a hypnotherapist I worked with, as well as pulled together information from past efforts on Weight Watchers and Jenny Craig. They don't count as medically supervised, but they do show a pattern.

I, like you, want this so badly I can taste it. I have been feeling quite anxious about finishing everything so I can seek approval. I'm not giving up, though. I believe this is the answer to me finally getting my weight under control. I encourage you to believe the same and stay the course.

All the best to you!

BeautyLocs