Jersey Boy

BC/BS does as of 2/16/08 require a six month supervised weight loss program

Horizon BC/BS of NJ does cover banding but be sure to get the list of requirements in writing as they change them from time to time. When I first saw Dr Bertha the only requirements were a referal from your PCP, a psych eval (which the do not cover), a consultation with a dietition,weight records for the last two years. Now (6 days before my scheduled surgery) they require a six month supervised weight loss program. and when they changed the requirements they said no exceptions.

Thanks Brandy~ I really need some encouragement

Jersey Girl, I too have BCBS (Horizon) of NJ and they made me do 6 month supervised diet. They didn't require that when my papers went in but they changed the requirements 6 days before my svheduled surgey date and said no exception. I have 2 more months to qualify, then resubmit. Does anyone know for sure if they use your starting weight or your weight after the six month supervised diet??? I too had a date before approval.

Angelica, thanks for your response. I was told by my doctor's office that I could jeoperdize my ever getting approved, once being denied, if I tried and they got upset, or I pissed off the wrong person. (pardone my French) When my paperwork went in they held it for two weeks, then after they changed the requirements,and they denied my request. Before that we only needed a referall from the primary care, Psych eval, nutricianist, and cardiologist. I also have most of the co-morbidities that go with being obese, and morbidly obese, for a long time. I only worry now that if I loose weight on the six month diet and get too close to a BMI of 40 will they deny me again, or say I've lost weight on a diet and that I don't need the surgery. I know that I can loose some weight but, I can't keep it off.

I don't think so I've tryed, with Horizon BC/BS of NJ and they say there are no acceptions

Horizon BC/BS of NJ does require a six month supervised weightloss progahm before approval. Up untill Jan16th they did not require it but they changed (six days before my scheduled surgery). I never did weight watchers or any other plan like that. But I'm working on it now.

Still waiting to complete the six month "supervised" weight loss program. Had everything all set even a date before the Isurance company changed the requirements for approval. now I'm in the middle of the six month period. I'm so glad to hear so many success stories. It is really encoraging.