Hello-- Question about insurance terms : )

[Harmonia 4]

Hello everyone. I am new to the forums. I'm happy to meet you all! I have a question. I asked my insurance rep what it meant- but he said my actual insurance company was very "vague" in the term and he encouraged me to basically grab whatever info I could from my PCP regarding past weight-related visits, just to basically have the theme of "weight" documented past visits.

The term I am referring to is, while my insurance does not require me to go on a 6 month diet or anything like that, it does say it requires "Documented failed medical weight loss history"

I asked my insurance rep if that entails failed diets "created" by my doctor, or if it included weight-related visits-- going to the doctor to discuss losing weight, going home and doing it, failing, etc. Basically, the specifics of the term. The rep told me what will likely happen is, with the info I can gather from weight related visits from my PCP, is that my insurance will either approve me (yay!) and it'll stop there, or if they deny me, whoever does the denials and responsible for giving the reason- will then be more specific about what it entails. Its a bit of a headache as I don't feel my insurance should be so vague in the first place so I know for sure : (

So I guess what I'm asking is, to possible people who had a similar criteria, or the exact same one preferably, what did it entail?

I have Independence Blue Cross, based in PA.

[Mrs. Reid 392]

I have a different insurance company, but mine meant I had to talk in detail to my nutritionist about all the diets I had been on. I talked about dieting since I was 12 years old. They also want you to mention that you tried weight watchers and failed. No one asked me for proof of all the diets I had done. I would not have been able to prove it as I didn't know I would need to produce the receipts.

[Harmonia 4]

I have a different insurance company, but mine meant I had to talk in detail to my nutritionist about all the diets I had been on. I talked about dieting since I was 12 years old. They also want you to mention that you tried weight watchers and failed. No one asked me for proof of all the diets I had done. I would not have been able to prove it as I didn't know I would need to produce the receipts.

Thank you so much! I appreciate the response. Right, it is quite weird to provide infallible proof of all the diets you've ever been on- for me, its not something I ever wanted to remember LOL, so there's no way outside of my doctor visits that I ever kept proof of my diets.

I wonder why Weight Watchers in particular that they asked for? To me, a diet is a diet, regardless of the way you mentally look at it which is essentially what Weight Watchers does- gives you a "refreshed" way to look at dieting.

Thanks so much for your response!

[Tammy O 8]

Harmonia - wondering how you made out with Independence BCBS. Hubby and I are both going for VSG, but I have not had a regular PCP until June of this year. I have Jenny Craig documentation, and am working on documentation from a nurse supervised program we did at a fitness center. We have started nutrition counseling, and all of the specialist consults we have to have. Curious how you (or anyone) made with with Independence BCBS documentation. Did you get approval? How long did it take? Thanks!