Hoping to get approved by BCBS

[Blondiemagoo 0]

Hi everyone. I have been to all of my appointments and now yesterday after scheduling my surgery my nurse walks in and tells me that BCBS of Michigan has changed their qualifications and that I needed 6 months straight of medically surpervised diet. I went on watching my caloric intake at the beginning of 2010 for 4 months did great until my doctor gave me adipex. Before all of this yeterday I stopped at my pcp to get the letter and she was rude to me and told me that she was not going to "lie" in the letter and that the insurance co. needed her to say that she has put me on a diet. #1 I never asked her to lie. #2 I have a co-morbid condition of severe sleep apnea and I am hoping this will be enough for the insurance company. I guess I am just a ball of nerves waiting to see if the insurance company will cover this or not.

[MelindaH 3]

Hi everyone. I have been to all of my appointments and now yesterday after scheduling my surgery my nurse walks in and tells me that BCBS of Michigan has changed their qualifications and that I needed 6 months straight of medically surpervised diet. I went on watching my caloric intake at the beginning of 2010 for 4 months did great until my doctor gave me adipex. Before all of this yeterday I stopped at my pcp to get the letter and she was rude to me and told me that she was not going to "lie" in the letter and that the insurance co. needed her to say that she has put me on a diet. #1 I never asked her to lie. #2 I have a co-morbid condition of severe sleep apnea and I am hoping this will be enough for the insurance company. I guess I am just a ball of nerves waiting to see if the insurance company will cover this or not.

Every BCBS plan is different. I would check with them. It depends on your bmi and how many co-morbidities they require.

Check with them.

All the best to you,

Melinda

[littlerlou 7]

This makes me nervous! I just changed my coverage to BCBS Community Blue (DTE, Michigan) because I was told by the surgeon and his office personel that they had the easiest requirements. My doctor wrote out the note and just jotted down all the diets I have tried within the last 10 years and that I had been on adipex for a year. My BCBS wont kick in until the first of the year but I hope they dont make it a 6 month diet requirement! So frustrating. And there is no where that you can actually read what exactly their policy is..When I called the 800 number the girl on the other end said that it was covered and that there was no requirements..but before she hung up the phone she did the little speach about ..."this does not guarantee and coverage is subject to change". Ill be so upset if it does change cause the whole reason I went with BCBS is because they said it was covered and no requirements needed!

[Dulci 108]

My doc's insurance coordinator requested my psp's treatment notes for the past year, which included the 9 months that I was on Adipex. The monthly weigh-ins and follow up for the Adipex were sufficient for my BCBS plan to approve the surgery, using that time frame as my "medically supervised" diet.

[Blondiemagoo 0]

Thank you everyone for your input. I have spoken with BCBS and they are still requesting the 6 months of medically supervised weight loss..........but the good thing is they have always requested it and with BCBS of Michigan they do not rrequire pre authorization. I spoke with benefits coordinator at my surgeon's office in Port Huron and she said as long as I had a letter from my doctor I would be fine. I am going to bite the bullet and speak with my doctor on Monday as I feel that I have this required documentation.