Did Anthem BCBS get rid of their 6 month supervised diet requirement?

[provenzee 262]

I have Anthem BCBS of Virginia and everything seems to be going well. I had my consultation, and first visit with my surgeon already. At that meeting I met with a coordinator who gave me a list of appointments/testing to complete before I see them again in six weeks. The coordinator told me that I am probably going to have the surgery in October or November. I asked the coordinator if I will be required to complete six months of supervised diet before approval, and she said all the insurance requires is to meet with a nutritionist twice within a six week timeframe and that I won't have to. I don't want to get my hopes up, so I was wondering has anyone had experience with Anthem BCBS? It says on their website they require six months. Unless they've accepted my previous attempts at weight loss even though I don't have six continuous months. I'm assuming the insurance coordinator at my surgeons office should know and be correct, right?

Edited July 22, 2015 by provenzee

[kathy0529 41]

@@provenzee I have Anthem BCBS in Massachusetts and never heard of the 6 month wait. I had my first appointment in November and surgery in January. Anthem was great to deal with and I'm still called by the nutrtionist to check on my progress. I'm 6 months out from surgery and she said she'd call 6 weeks from the last call. Not sure how long the calls will go on from Anthem, but if I miss the call, I just email her how I'm doing.

Good luck!!!

[hockeyfan7 249]

I had that requirement in 2012 but not for my band to sleeve revision in June. My doctor just wrote a letter that I had been doing WW for six months and had done Atkins and several other programs before that without being successful and the insurance accepted that.

[Sharon1964 2,530]

. I'm assuming the insurance coordinator at my surgeons office should know and be correct, right?

I wouldn't assume that. I would call the member services number on my insurance card and ask them directly.

[kninica 0]

Did you ever find out? I'm starting the process in VA and would love to not have to wait 6 months

[uhm.mazing 1]

I have BCBS or MA, was there a 6 month requirement?

[elalala 4]

I have Anthem BCBS of California and 6 month of medically supervised weight loss is required. The surgery policy for Anthem is located here: https://www.anthem.com/medicalpolicies/policies/mp_pw_a053317.htm

The policy specifies that 6 month of MSWL is a requirement but I think that some different Anthem plans can have different requirements.

[Allie589 171]

I have Anthem BCBS of California and 6 month of medically supervised weight loss is required. The surgery policy for Anthem is located here: https://www.anthem.com/medicalpolicies/policies/mp_pw_a053317.htm
The policy specifies that 6 month of MSWL is a requirement but I think that some different Anthem plans can have different requirements.

Same for me out in CA. My surgeon said you could get a letter from god saying you need to have the surgery asap and they wouldn't care. Both my OB and endocrinologist wanted me to wait as little time as possible but BCBS still made me wait the 6.


5'7 HW: 256 SW: 248
CW: 235 At 2 week post op GW: 150
Fantasy GW: 135 Sleeved 8/7

[Starsmore 60]

I have Anthem BC and I emailed to ask. They said that six months of supervised weight loss was required, but I was already able to meet with the surgeon and I have all the preop testing scheduled and approved, so I'm not sure what the deal is....

[chica320 18]

I have anthem bcbs of ca and I had to do 6 months with a nutritionist but was able to do all the other requirements while doing the 6 months. I have 1 appointment left with nut then I have my pre op testing a few days after that. I didn't loose any weight with in the 6 months, if any a pound or 2 those with my insurance have you heard them decline because you didn't loose weight?

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[Natashca 22]

HI Chica320,

I have Anthem BCBS of Georgia. I have finally finished my required 6 month supervised diet. I don't think that they've rejected a claim for not losing anything. Do you have a Nurseline that you can call? With my plan I have a nurse assigned to me to answer any questions and to help streamline the process of approval.

Tasha

[newnew1 11]

Hi Chica320 I have Anthem BCBS of GA and Anthem does require 6 consecutive visits. I had 4 visits from 2 years ago that my coordinator said lets see if they would accept and they denied it.they did however approve all my labwork, psy visits recommendations etc so i nkw have a case file with them so the only thing pending is 2 more visits (Oct and nov). I was told once I meet w the dietician in Nov they will resubmit the next day and I should hear from BCBS within a week..so I'm like the rest of you waiting..i just need to get scheduled by December 31st. Not trying to start over with deductible requirements.. Good luck! It'll go by so fast. It already has for me and I'm setting nervous and anxious at the same time..2 more months to go!!

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