BCBS NC 6 Month Supervised Diet Maybe Changing as of July 1, 2014

[Danalodon0825 21]

During my bariatric appt today I learned that the 6 month supervised diet may be no longer after July 1, 2014 for BCBS NC policy holders. The Bariatric Association has been arguing that the 6 month supervised diet requirement has shown no benefit for many individuals seeking insurance approval and it prolongs on-going medical issues of many.

As we all know some individuals benefit from having to wait 6 months before surgery (more education, planning, etc.). However some individuals are dangerously obese and want to start their journey to becoming healthier.

I did not want to wait, I've been educating myself over the past 3 months (everyday) because I'm ready for a change. I've always been overweight. I have 2 pages of past diets and I can't count how many times I've tried to starve myself so I wouldn't put calories in my body (hoping my body would burn the fat). I know some may say that was stupid, it was but I've always wanted to look healthier. I have a very nonexistent metabolism. I have to work out 7 days a week, 30 days a month to see results. Realistically I don't have the time with career, 3 children, husband and household.

I learned this morning that I only have to complete my endoscopy and psychological. Then I can see my surgeon and get scheduled for surgery!!

Anyway I didn't mean to get off topic but I'm really excited !! I will definitely keep you posted if i hear more regarding BSBC NC decision. Hope this helps someone.

[mentalistfan 189]

The BCBS of IL already did away with the six month supervised diet but a lot of surgeons and patients aren't aware of it...I got a copy of my policy and sent it to my insurance coordinator at the surgeons office, no one believed me lol.

[BetterNai88 54]

Wow I have my 5th of 6th visit on Monday if I could do away with the 6th on 7/30 and get sleeved earlier that would be great

[beachgurl84 456]

I'm in month 2 of the 6 month program and i've been stressing about being able to get the surgery in by the end of the year to maximize insurance benefits. I don't/wouldn't mind doing the 6 month program but if I can get it in sooner I will definitely pursue that!!

You said it was during your bariatric appointment you heard about this. Was that from your surgeon, insurance specialist, nurse? I'm wondering if I call my insurance agent today will he have any info you think?

[Danalodon0825 21]

The entire Bariatric Team was buzzing about it, everyone is ready to see if this change is going to happen. I know a lot of people who will benefit from the change.

[Danalodon0825 21]

Yes your insurance agent should be able to give you information about it. My doctor informed me the decision will be given on July 1st. But please let me know what you hear from your insurance agent.

[beachgurl84 456]

He just responded to my email and said he had not heard anything about it yet but he will keep me posted if he gets news. Also, I found this website https://www.bcbsnc.com/content/services/medical-policy/updates/index.htm that list the policy changes for BCBS NC. I bet it will be posted there as soon as the decision is made. However, if you notice on that page that when a change is posted, it usually isn't effective for a few more months. So we may still have to wait till the september/october time frame.

[DeeSleeved427 7]

I have CIGNA and in NC, I have the 6 month wait, won't have my 6th visit until Oct 21st so I hope the July 1st changes (if approved) travel through my insurance pipeline as well! Thanks for the info and best wishes to you all!

[mm717 0]

@ danalodon0825 I also heard this from my doctors office! I hope it's true!! Which doctors office are you going?

Edited June 29, 2014 by mm717

[Danalodon0825 21]

Hi, I'm having my surgery through Southern Surgical Associates in Greenville, they are awesome. I hope the change happens, I think it would be beneficial for many including myself.

[beachgurl84 456]

So hopefully today is the day BCBS makes our lives easier. Looking for updates regularly. Stay in touch.

[mm717 0]

I'm hoping and praying for this too.

[bookqueen 0]

BCBSNC denied me because of my 6 appointments during the six months, one of them showed that I also had a sinus infection and discussed it so it wasn't strictly a "weigh in" discussion. My surgeon's office also told me they were hopeful that the decision would change today and that they should know early this morning and would be calling those of us who it applied to. I haven't heard anything so I'm assuming the news is bad. This is so lame. Luckily we think we can do the 3 and 3 records. I have three (actually 5) appointments accepted from my first try and I've now seen my surgeon twice. So I have to wait so many days and go back, for me it's July 15, and hopefully then we can get approval and schedule surgery. This really sucks because I'm a teacher and have been planning to do this while out for the summer so I won't have to take sick time for recovery as I don't have a lot. Anyone else heard anything today?

[beachgurl84 456]

I've been watching the BCBS website all day for policy changes. While they have listed some, they haven't listed anything about this surgery. BUT....they also haven't updated the corporate medical policy to show a 2014 review so maybe they just haven't gotten around to it yet. Stay hopeful.

[tmspears3 1]

Has anyone heard of BCBS of AL doing this also. I have tried to find it online but couldn't. I"m almost 2 months into the 6 ;( seems like forever.