iwalktheline

I think they are trying to stall you and make you give up. If you get down in the 190's they will deny you. I really hope that this works out for you. I am kind of in the same boat, but it is the med group making all the rules not the insurance. GOOD LUCK

Hi All, I have bcbs IL and was told that I needed a referral from PCP to do lap band, no other requirements. My PCP Group requires 6m supervised diet. Do I really go on low cal diet and exercise and work it for 6 months. I bet I could lose 30lbs. Problem is that I have a BMI of 36(w/htn, dm2, carpal tunnel, oa). I don't know what these people really want. I am sure if I lose a bunch of weight they will deny me and I will be crushed. The problem has never been losing, it's keeping it off. I will lose the weight in 6 months and in 2 years I will have blown up and added more. If anyone knows what is really expected out of the 6m diet please let me know. I just don't want a denial in 6 months. I will be devastated. Thanks

I would like for people to share their experience w/lapbanding time lines. From the decision "I am going to get lap banding" until the actual day of surgery how long did it take. I really appreciate everyones stories because I feel like the 6 month "supervised diet" is just a stall tactic for my insurance. I have 20 years of diets and massive weight gain to show. Thanks:drool:

what kind of insurance do you have and did you have to have a referral from your doc?

If your BMI is over 40 it is just a matter of time before you get approved. APPEAL and get your Doc to write a letter about how it is life or death. GOOD LUCK

I have bcbs/il HMO and decided to have lap banding. I called bcbs and asked what my coverage was and the cs said that it is covered 100% if there is a referral from my PCP deeming it med nec. I was sooo happy that I felt like my life was going to finally be worth living because I wasn't stuck in this HUGE body with so many med problems. WELL I WAS IN FOR A BIG SURPRISE. I went to the office and asked the Doc for a referral. She looked at me like I was crazy stating "Ive never had anybody ask me for such a thing" and "why would I want to go to such drastic extremes to lose weight" and there medical group requires 12 months of supervised weight loss to even consider a referral. I just started to sob. I felt like someone and just CRUSHED MY SPIRIT. so now I am going to switch to another group that requires 6months of dieting. I have a BMI of 36, but hypertension, pre diabetic, severe carpal tunnel, swollen knees, hyperlipidemia etc. All because of weight. I have lost and regained over 500lbs in 20 years. I truelly believe I will end up dead in my 60's if I dont' lose and maintain wt loss soon. ANY ADVISE IS WELCOMED