All insurances are different. There are even some Blue Cross Blue Shields insurance that are different... some are 3 month and some are 6 month medically supervised weight loss. And each doctor does ask for difference clearances depending on your health and history. Like if u are a smoker or ever were, the doctor could and should ask for pulmonary clearance... or if u have sleep apnea, pulmonary. Some patients have to go to endocrinology for hormone issues...