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Is there any reason not to start heavily dieting now?



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Anyone have experience with Blue Cross/Blue Shield of Michigan? I had the 6 month diet waived because I was over 50 BMI. I got approval and have a surgery date scheduled. I have lost weight faster than I expected and am certain I will be under 50 BMI by surgery time. Is BCBSM going to yank my approval at surgery date? Will I still have surgery and they decide not to pay and I'm stuck with the bill?

I have BCBS of Michigan. I was worried about this as well. My starting BMI was like 50.2 and I lost quite a bit of weight. I called BCBS and they actually aren't that specific in their policy coverage. I had them send me the coverage and it just says you if your BMI is over 50 the 6 month diet is weighed. Nothing more specific.

The rep at BCBS even put me on hold while she checked with her manager. They agreed the policy isn't specific and felt as long as it was at 50 when you were recommended for insurance you would be fine. I figured it was vague enough to fight if they denied it. I just got my first insurance statement post-surgery (it was for the surgical anesthetic) and they paid everything but my $20 co-pay.

Sorry I have nothing more definitive, but I think you should be ok. You might want to call them yourself to see if your answer matches the one I got.

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Anyone have experience with Blue Cross/Blue Shield of Michigan? I had the 6 month diet waived because I was over 50 BMI. I got approval and have a surgery date scheduled. I have lost weight faster than I expected and am certain I will be under 50 BMI by surgery time. Is BCBSM going to yank my approval at surgery date? Will I still have surgery and they decide not to pay and I'm stuck with the bill?

I have BCBS of Michigan. I was worried about this as well. My starting BMI was like 50.2 and I lost quite a bit of weight. I called BCBS and they actually aren't that specific in their policy coverage. I had them send me the coverage and it just says you if your BMI is over 50 the 6 month diet is weighed. Nothing more specific.

The rep at BCBS even put me on hold while she checked with her manager. They agreed the policy isn't specific and felt as long as it was at 50 when you were recommended for insurance you would be fine. I figured it was vague enough to fight if they denied it. I just got my first insurance statement post-surgery (it was for the surgical anesthetic) and they paid everything but my $20 co-pay.

Sorry I have nothing more definitive, but I think you should be ok. You might want to call them yourself to see if your answer matches the one I got.

That's basically what I got. They mailed me the requirements but it's not specific on what weight is used for BMI. I figured since I'm already approved I should be good but I don't want surprises.

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My BCBS did even require "authorization". If you met the criteria, you're qualified. Then there were certain things I needed to do like a recommendation/clearance from my PCP, psych visit, EGD. But never had to presubmit any of that.

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My surgeon did not require me to lose any weight. My NUT said that didn't mean I couldn't or shouldn't try. My insurance coordinator warned me not to lose too much during the 6 month insurance workup. Talk about mixed messages!

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All these rules about qualifying BMI vary by insurance policy, surgeon, and more.

For those of you who want to lose weight pre-op, but are worried your qualification will get screwed up if you lose too much, consider this:

You can buy weight belts that have slots for half-pound weights for a total of up to ten pounds. You can slip those half-pound weights in your pockets, bras, underwear, shoes, socks, etc. to compensate if you've lost "too much" weight pre-op.

Theoretically speaking, of course. I would NEVER have done anything like that myself.

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