Question:
Do I have to do 6 months?
My BMI is 41.2. I've tried every diet. Do I have to really do the 6 months doctor supervised weight monitoring in order for my insurance to cover it? I have bc/bs highmark ppo. Anyone know? — queenie38 (posted on June 16, 2009)
June 16, 2009
I have the same insurance and have had to do the diet-my time will be up
next month. At first I was really annoyed that I had to meet this
requirement, now I am grateful. During that time I researched my surgery
and ended up changing my mind about which surgery I wanted. It has also
given me time to make some behavioral changes so I'm not overwhelmed with
having to do all of them after surgery. Believe me, it goes by fast. View
it as an opportunity. I also don't lose weight easily but you'll be ok as
long as you don't gain, and I bet you lose a few pounds in the process.
Don't let this requirement depress you. You can do it! :)
— Jung
June 16, 2009
i have bc/bs state plan of north carolina.i did not have to do this,just
the normal like psych eval,NUT and have the high bmi.
— carolyn1970
June 16, 2009
sry i forgot to say my insurance is also ppo.
— carolyn1970
June 16, 2009
The only way to know for sure about the 6 month deal is to just call your
insurance co. and ask. That will put your mind at ease. Good luck, you
can do it!
— katiecakes
June 16, 2009
yup. you do. my BMI was higher than yours. i can't say it will "go
by fast" but 8 months ago i was in that situation and now i am 7 weeks
post op. :)
— greenpunchbuggie
June 17, 2009
If you have tried any weight lose programs in the past like Jenny Craig or
Weight Watchers, they might count that as part of the requirement. I had
been on them years before and I just called them and got proof that I had
tried them. I also had my weight watchers stamp card that I saved, I don't
know why I saved it but I am glad I did.
So with having this already, I didn't have to do the 6 months. Try to see
if you can gather information from any or all weight loss centers and also
put on the form from your doctor that will submit the info all the
diets/pills/drinks anything related to weight loss, you have tried. Best
Wishes
I am sure that we have all in some point and time during our desire to lose
weight has tried Jenny Craig or Weight Watchers at least once. I tried
Jenny Craig twice and only lost 15 lbs total and WW I was on it for a year
and only lost 27 lbs. Don't forget about EDiets or NutriSystem too.
— Kristy
June 17, 2009
I have Keyston Health Plan East I know that require 6 months of weight
management. Now some surgeons office double up on the visit to make it
shorter wait time. My doctor had me come in twice a month for three months
and the equaled out to my six months. See if your doctors office and do the
same. Good Luck it will go by fast
— DonnaRo
June 17, 2009
Call your insurance company to see what the requirements are and get
specifics. I had to have done the 6 months within a certain time from
surgery so all of their requirements are different. Good luck.
— [Deactivated Member]
June 17, 2009
I have bc/bs DC ppo plan, and have to do the 6 months of classes. The
reason they make you do those is in hopes you will miss one and they won't
have to pay for your surgery... that's the bottom line. So, make sure you
go to every class and that they are in the required times (i.e. a certain
number of days following your previous class and a certain number of days
prior to the next one). If you mess up on them, you get to start all over,
so make sure you get them done on the correct time schedule. Plus, the way
the ins. comp. counts it is like 7 months almost. Good luck!
— Libby R.
Click Here to Return