newmeme 9 Posted February 3, 2016 I found out today that I have been approved for bariatric surgery!!!! I have been calling the Anthem pre-authorization line to check on my status for the last 4 days and I finally received clearance today. Hip hip hooray!!!! They confirmed that they received my paperwork on 1/26 so the review took about 6 business days. I just wanted to write a post because I, like many others, struggled with understanding the 6 month weight loss requirements in my policy. Basically the policy states you have to have 6 months of documented weight loss attempts in the previous 2 years. I am 5'4, 260 lbs w/ a BMI of 44 (also a 33 y/o female). When I visited my doctor (Dr. Jossart in San Francisco) I provided him an chronological outline of my past diets (Atkins, Paleo, HCG, Weight Watchers) and exercise efforts (half-marathon, Cross-fit, personal training, boot camps). None of these activities were medically supervised. Although I do not have any comorbidities, we also went through all of my various ailments (depression, joint pain, plantar fasciitis, rashes, etc.). I am not 100% sure what he wrote in my referral, but it worked!! All I can say is: there are no guarantees, but have faith in your surgeon! 12/18 - first contact w/ doctor's office - scheduled consult 12/27 - psych evaluation ( I got a head start due to the long lead time for my apt) 01/22 - bariatric surgeon and nutritionist consultation 01/26 - Insurance received paperwork 02/02 - Insurance approval TBD - surgery date Good Luck!!!! Share this post Link to post Share on other sites
careya123 260 Posted February 3, 2016 Woo-hoo!!!! Congratulations! Share this post Link to post Share on other sites
xochtlem 54 Posted February 9, 2016 That's awesome news, congratulations!!! It's also very helpful seeing that Anthem of CA was very quick with the approval. I participated in a medical weight loss program last year and provided my surgeon's office with documentation of the visits. They told me it looked like enough for Anthem, so your post gives me hope mine will be approved without any issues. Thanks for posting! Share this post Link to post Share on other sites
The Candidate 3,215 Posted February 9, 2016 Congrats on your approval! Share this post Link to post Share on other sites
bosschick_vsg 6 Posted February 10, 2016 I found out today that I have been approved for bariatric surgery!!!! I have been calling the Anthem pre-authorization line to check on my status for the last 4 days and I finally received clearance today. Hip hip hooray!!!! They confirmed that they received my paperwork on 1/26 so the review took about 6 business days. I just wanted to write a post because I, like many others, struggled with understanding the 6 month weight loss requirements in my policy. Basically the policy states you have to have 6 months of documented weight loss attempts in the previous 2 years. I am 5'4, 260 lbs w/ a BMI of 44 (also a 33 y/o female). When I visited my doctor (Dr. Jossart in San Francisco) I provided him an chronological outline of my past diets (Atkins, Paleo, HCG, Weight Watchers) and exercise efforts (half-marathon, Cross-fit, personal training, boot camps). None of these activities were medically supervised. Although I do not have any comorbidities, we also went through all of my various ailments (depression, joint pain, plantar fasciitis, rashes, etc.). I am not 100% sure what he wrote in my referral, but it worked!! All I can say is: there are no guarantees, but have faith in your surgeon! 12/18 - first contact w/ doctor's office - scheduled consult 12/27 - psych evaluation ( I got a head start due to the long lead time for my apt) 01/22 - bariatric surgeon and nutritionist consultation 01/26 - Insurance received paperwork 02/02 - Insurance approval TBD - surgery date Good Luck!!!! Good for you I have BCBS PPO of Suffolk County I hope they are as fast with their approval process. Share this post Link to post Share on other sites
Sumaire 75 Posted March 9, 2016 I'm still waiting for approval. I've tried so many diets, it's insane, but none have been long term successful. The Scarsdale Diet, Atkins, paleo, etc, and no luck. The only time I lost weight and kept it off (for a time, anyway), was when I was taking Adderall for my ADD. When I could no longer afford the psychiatrist visits, no more prescription and my weight went from about 235 up to 299 at its highest (I'm at 283 and holding right now). Anyhow, you shouldn't have to take drugs to lose weight. That's nothing that's going to last in the long run. Share this post Link to post Share on other sites
newmeme 9 Posted March 11, 2016 I'm still waiting for approval. I've tried so many diets, it's insane, but none have been long term successful. The Scarsdale Diet, Atkins, paleo, etc, and no luck. The only time I lost weight and kept it off (for a time, anyway), was when I was taking Adderall for my ADD. When I could no longer afford the psychiatrist visits, no more prescription and my weight went from about 235 up to 299 at its highest (I'm at 283 and holding right now). Anyhow, you shouldn't have to take drugs to lose weight. That's nothing that's going to last in the long run. Keep us posted on your status! I'm keeping my fingers crossed for you. Share this post Link to post Share on other sites
Sumaire 75 Posted March 11, 2016 I will, thanks. It's just frustrating, as I'm not a patient person. Sent from my iPhone using the BariatricPal App Share this post Link to post Share on other sites
FreeTheSkinny66 9 Posted March 16, 2016 (edited) That's terrific! I have Anthem BCBS (in CT) and my surgeon's office told me that my almost 8 months of doctor supervised dieting (which required me to meet with a coach and get weighted and have my fat and hydration %s checked weekly) was not good enough for insurance because it was in 2014. Even though Anthem's guidelines state within the last 2 yrs. So I have to go through 6 months at the doctor's office. Doesn't that just sound silly?? Edited March 16, 2016 by FreeTheSkinny66 Share this post Link to post Share on other sites