mommabear2311 31 Posted September 9, 2016 My frustration between my insurance company and the weight loss center is growing bigger each day. I called my insurance BCBS MICHIGAN , they tell me that if my BMi is over 50 I bypass the 6 months of weight monitoring and that I don't need a prior authorization. The weight loss center looks at me like I'm making it up. Please I just want to have my surgery. Am I over reacting? I just feel like I'm running around the bush doing unnecessary things. Ugggg!! Share this post Link to post Share on other sites
Valentina 2,642 Posted September 9, 2016 I would suggest two things: 1. Get your information about not needing any prior authorization with your BMI over 50 in writing. 2. Get your insurance company and The Weight Loss Center on the phone together. Don't give up. Sometimes I think that "they" purposely make things confusing in hopes that you will give up---saving them thousands and thousands of dollars. Be assertive----NOT aggressive and I bet all will work out. Please keep posting and letting us know when your WLS date is! Share this post Link to post Share on other sites
slvarltx 332 Posted September 9, 2016 I have BCBS of MI as well... I had to follow a 6 month program...is that an option for you? The 6 months was actually good as i could practice the new eating habits, plan my schedule around surgery/recovery, etc Sent from my iPhone using the BariatricPal App Share this post Link to post Share on other sites
lelewatson 51 Posted September 9, 2016 I have BCBS of Michigan as well. My BMI was 42 I think. The weight loss clinic that I went to closed but my PM doctor knee I went for over a year so she wrote me a letter. If you can get your regular doctor to write the letter, do that. Sent from my VS985 4G using the BariatricPal App Share this post Link to post Share on other sites
lelewatson 51 Posted September 9, 2016 I have BCBS of Michigan as well. My BMI was 42 I think. The weight loss clinic that I went to closed but my PM doctor knee I went for over a year so she wrote me a letter. If you can get your regular doctor to write the letter, do that. Sent from my VS985 4G using the BariatricPal App My doctor also knew I had been working very hard on my weight as we went to the same gym. Sent from my VS985 4G using the BariatricPal App Share this post Link to post Share on other sites
KristenLe 5,979 Posted September 9, 2016 @@mommabear2311 My BMI is 52+ and BCBS of RI waived my 6 month supervised diet requirement (of course, no one told me that until I was in my 3rd month). Anyway - although the diet requirement is waived the not needing prior authorization does not make sense to me at all. I would ask that the insurance coordinator at your surgeon's office look into what steps are needed to get prior auth. My plan still required them to submit all of the documentation for authorization - it was just the 6 month supervised diet wasn't required. It is doubtful the surgeon will proceed without a prior authorization. I did find that most of the information I got from the BCBS reps was inaccurate or not complete. Share this post Link to post Share on other sites
nolady 7 Posted September 9, 2016 Could you be confusing a prior authorization with the requirement of doing the 3 to 6 month weight-loss before surgery? I also have BCBSM and my BMI is in the category that does not require the 3 to 6 month weight loss period But I still require an authorization from the insurance company. Sent from my iPhone using the BariatricPal App Share this post Link to post Share on other sites
