Feeling overwhelmed and discouraged

[kdecker19 0]

Hello everyone

My husband and I are in the very beginning process, and are working on this together. I am confused on steps that are upcoming and very concerned in the end I may not qualify. I was hoping to hear from some of you near the end of the process and maybe get some insight. So far we have found a surgical group we like and attended the required seminar. We have BCBS of Michigan and they require the 6 months of physician supervised weight loss attempt. I am on month 2 with my PCP but considering doing the long drive and finishing this with my surgical office. We are both right at about 40 BMI. He has co-morbidities and will be okay even at 35 BMI. I do not have any obvious co-morbidities, (looking for help on some off the wall things they consider co-morbidities) so I have to maintain the 40BMI. With the requirements for the insurance I am not sure how to go about the weight loss attempt. Some say that the insurance company only looks at the beginning BMI some say not to lose and stay at 40 BMI throughout. I am waiting for a packet from the insurance company that will possibly give me more insight. It sounds like the next appointment won't be for 3 months with the surgical group. I guess I am feeling a little lost on the process and I am worried I am going to mess up one little step and not be able to get the sleeve. Any advice, especially anyone dealing with BCBS of Michigan would be greatly appreciated. Thanks.

[akay02 1]

Hello everyone

My husband and I are in the very beginning process' date=' and are working on this together. I am confused on steps that are upcoming and very concerned in the end I may not qualify. I was hoping to hear from some of you near the end of the process and maybe get some insight. So far we have found a surgical group we like and attended the required seminar. We have BCBS of Michigan and they require the 6 months of physician supervised weight loss attempt. I am on month 2 with my PCP but considering doing the long drive and finishing this with my surgical office. We are both right at about 40 BMI. He has co-morbidities and will be okay even at 35 BMI. I do not have any obvious co-morbidities, (looking for help on some off the wall things they consider co-morbidities) so I have to maintain the 40BMI. With the requirements for the insurance I am not sure how to go about the weight loss attempt. Some say that the insurance company only looks at the beginning BMI some say not to lose and stay at 40 BMI throughout. I am waiting for a packet from the insurance company that will possibly give me more insight. It sounds like the next appointment won't be for 3 months with the surgical group. I guess I am feeling a little lost on the process and I am worried I am going to mess up one little step and not be able to get the sleeve. Any advice, especially anyone dealing with BCBS of Michigan would be greatly appreciated. Thanks.[/quote']

I also deal with BCBS of Michigan, where abouts are u at? I would stick with the same PCP though out your six months. The insurance is very picky. I don't have any co-morbidities as well, my surgeon says they use your starting BMI and you just get a jump start on the whole process by losing anything you can. I have one month left with my requirements and getting very nervous. I'm not good with even the thought of surgery but willing to put myself it cause it's something I really want.

[kdecker19 0]

I am in the GR area. I am hoping I can jump through the hoops and get approved!! Where are you at??

[akay02 1]

Near Detroit

[abj 11]

Hello everyone

My husband and I are in the very beginning process' date=' and are working on this together. I am confused on steps that are upcoming and very concerned in the end I may not qualify. I was hoping to hear from some of you near the end of the process and maybe get some insight. So far we have found a surgical group we like and attended the required seminar. We have BCBS of Michigan and they require the 6 months of physician supervised weight loss attempt. I am on month 2 with my PCP but considering doing the long drive and finishing this with my surgical office. We are both right at about 40 BMI. He has co-morbidities and will be okay even at 35 BMI. I do not have any obvious co-morbidities, (looking for help on some off the wall things they consider co-morbidities) so I have to maintain the 40BMI. With the requirements for the insurance I am not sure how to go about the weight loss attempt. Some say that the insurance company only looks at the beginning BMI some say not to lose and stay at 40 BMI throughout. I am waiting for a packet from the insurance company that will possibly give me more insight. It sounds like the next appointment won't be for 3 months with the surgical group. I guess I am feeling a little lost on the process and I am worried I am going to mess up one little step and not be able to get the sleeve. Any advice, especially anyone dealing with BCBS of Michigan would be greatly appreciated. Thanks.[/quote']

I am in my second month of doc supervision for ins also. (Unitedhealthcare). I am told it has to be 6 consecutive visits 1 month apart. My ins girl at surgeons office says this is very important, they can turn you down if not done properly. For that reason, if I were you I would continue where you started. The BMI reported to ins in the beginning is what matters. If it fluctuates before surgery, should not be a issue. Hope this helps.

[Pixie Dust 526]

Exactly what ABJ said! My husband works for BCBSM & he said it's the initial BMI that counts. Do not skip your monthly visits either. Good luck to you!

[kdecker19 0]

Thanks everyone! Pixie dust thanks for the clarification I am feeling so miserable and would like to start walking and working towards loss but have been so afraid to lol. I go to "official" first appointment at the surgeon office next week so I am sure I will get more info.