Anthem BCBS Requirements

[elalala 4]

Hi all! I have just started investigating having the VGS and I had my first consultation last week. The insurance specialist there told me that the 6 months of medically supervised weight loss has to be done at the surgeons office, and cannot be with my PCP, and that she confirmed this with my insurance. I called my insurance and they are looking into it and said they will get back to me. Has anyone who has Anthem BCBS done the 6 months with someone outside of the surgeons office (ie: your PCP, a nutritionist not affiliated with the surgeon)?

The reason I want to find this out if that I've already completed a 6 month weight loss program with my PCP, and I am hoping I will be able to use that to cover the insurance requirement. He has agreed to write up whatever letters I'll need also.

Edited July 30, 2017 by elalala

[mikemy 12]

I have Anthem. I was required to do a 6 month supervised weight loss program also but I was able to do it with my pcp. I had to go in 1 time every month and log what I was doing to lose weight. I had my sleeve done in April of 2016. I would think the insurance company would cover it if you've already done it. I also had to have my pcp write a letter explaining all my health issues and that this procedure would be the best option for me and my health. Good luck

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[zallykatz16 56]

I have Anthem and I have had to do 6 months with my PCP about weight loss. My surgeon said that I had done all the requirements so I keep my fingers crossed. I have surgery in early September.

[Tuvmeister 0]

I have Anthem Blue Cross (California) and I had done a medically supervised weight loss program previously with a different doctor about two years prior to surgery. Because the medically supervised weight loss program was at least 6 months long and started 2 years prior to surgery, it was accepted and I got first letter approval for VSG. Good luck!

Edited July 31, 2017 by Tuvmeister

[AZLoser 103]

I have BCBS. I did the pre op with my surgeons office. They would not accept a nutritionist. They would have taken my PCP but he doesn't do that part.