Hey.. I live in Buffalo.. And l have bcbs as well.. Yes, you need a 6 month, "medically supervised" weight loss program... This can NOT be done by the bariatric surgeons office... So your best bet is to join weight watchers for six months, during that period, visit with your primary Dr 3 times, where he/she "councels" you on weight loss.. Be sure your Dr writes this info in the Dr notes, and you get a copy of it to submit to your ins... Oh, by the way, you must FAIL at weight watchers.. If you lose too much, they will assume u dont need surgery.. Because of bcbs, my process took a year, but l finally had my surgery this past tuesday...