Question about x months supervised weight loss program for insurance

brians34
on 7/2/14 2:11 am - Robinson, TX

I have a question for those that have been through the insurance hassels.

I have Blue Cross insurance and one of the requirements it states:

"Participation in a medically supervised weight loss program, including nutritional counseling, for at least 3 months prior to the date of surgery. (Note: Benefits are not available for comercial weght loss programs)."

If your insurance had something like this, what did you do to meet this requirement?  I am gonig to call my insurance, but would like to see what other's have done before doing so to have a better idea how to ask what needs to be done.

civilmomma
on 7/2/14 2:13 am, edited 7/2/14 2:13 am
VSG on 03/07/14

I have BCBS as well and had a 6 month requirement.

The bariatric clinic I went through has a program in place that is sure-fire for getting approval.  I saw the NUT through the bariatric program so all my records are right in one place.

I had done 6 months of weigh****chers on my own, but b/c I hadn't gone to my PCP to weigh in every month, it didn't count and I had to start all over with the monthly NUT visits.

 

From my experience "medically supervised" means you have to go to the doc or NUT monthly to weigh in and "discuss weight loss".

     ticker5'-8",HW 347,SW329,M1-25 M2-17 M3-11 M4-13 M5-14 pregnant-->

 

Brina78
on 7/2/14 2:30 am - San Diego, CA

HI There..

I have BCBS and i had to do the 6 months of supervised diets...I did them through my Primary Care doctor...would go once a month...after I completed my 6 months...she gave me the referral for the surgery...then i saw the surgeon...had to do labwork...ekg...pysch eval...nutrition visit...once all that was done...i got my approval.

My insurance pretty much guarantees approval it if you meet the criteria they establish.

Good Luck!

amyvsg6614
on 7/2/14 9:16 am
VSG on 06/06/14

I have BCBS and I did the same as you.. except I had to also do a fitness evaluation.. 

    
brians34
on 7/2/14 2:35 am - Robinson, TX

Thanks for the responses.  I did just talk with insurance customer service and they told me that the surgeon's office usually sets up an appointment to go over everything that is needed and helps get set up with what is needed.

I'm just ready to get it going.  Just finished the seminar a couple of weeks ago and waiting for the surgeon's office to contact me.  Hate the wait, want to get started.  I guess I'm just going to have to sit on my hands for a little while longer and wait to hear from surgeon's office.

Crissy00
on 7/2/14 5:35 am - Washington, DC

I know the feeling I been taking the time to get back into the gym, changing my eating habits, trying different shakes etc..........and the time is moving fast I only have 2 more months of the program left

GCoop
on 7/2/14 3:02 am
VSG on 07/03/14

I have BCBS and had the same 3 month requirement.  My surgeon's office had a supervised program where I went monthly to weigh in and attend classes.  

HW: 237. SW: 222.8 (07/03/2014)

CW:  189.3 (09/21/2014)

 

        

jqcwife
on 7/2/14 3:53 am - Malvern, AR

I had to do 6 months with mu PCP.  I had my last appointment with her Tuesday and my consult is the 8th and surgery is on the 23rd.  I was in communication with my surgeon and was able to do all the stuff he requires during the 6 months.

Jules78
on 7/2/14 4:04 am - GA
VSG on 05/01/14

I also had a 3 month requirement with AETNA and went thru my surgery center.  They basically did everything all you have to do is show up to the appointments, however I did get my psych eval and dietician visit outside of their program as it was cheaper.

   youtube channel- silkiilocks

 

tennisrob101
on 7/2/14 5:07 am - MD

I have a 6 month requirement also with Coventry and was told the only thing that counted was with a doctor when we discussed my weight and diet for the month. My surgeon has a program in his office that also includes nutrition.

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