Insurance changed!

[Mari01 0]

My insurance changed! I started my journey November 2018, with a consult with my (then) surgeon at Riverside Medical Clinic. With my (then) insurance, Anthem Blue Cross ***, I only needed 3 month (12 continuous classes) supervised nutrition/weight classes. As of now, I finished 10 out of my 12 classes. Last week I found out my insurance changed to Anthem BC PPO and they now require me to go to a Dignity Health Facility to be covered 100%. Well okay... I call my nearest Dignity Health bariatric surgery center to find out more.

I was told at Western Bariatric (St. Bernadine -- San Bernardino, CA) that I needed 6 months of classes and basically restart my journey. I started to bawl my eyes out! I'm 25 (November birthday) and I'm getting real close to end of my insurance coverage under my parents. When I had started my journey, I was hoping to have my surgery by March or April. So, I'm worried about having my surgery before my cut off. Anyway, I sucked it up and started making calls. I attended their Seminar, where we filled out new patient packets and made copies of our insurances.

The next step is to wait for a call to schedule my consult with their surgeon. I was told that the consult would count as 1 of the 6 months of weight classes.

Does anyone believe they will accept my 3 months of classes Ive already taken? (and maybe only need 3 more months to meet the 6mo requirement?)

Will they consider the original surgeon consult from November 2018 too (as part of the 6 months wight management?)

I'm honestly hoping that Western Bariatric will consider my start (Nov.) to my current (Feb.) for a total of 4 out of the 6 required months. I didnt want to be set further back, but ill take whatever they'll take and Im hoping for the best!

Can anyone can give me some insight? Similar situations? Anyone go to Western Bariatric? I'm really anxious.

[49Nash 103]

I have zero insight on your insurance issue but I just wanted to say I’m sorry for your setback. I will say I went through an extensive program to be prequalified for my insurance. And when I finally went to the surgeon I still had to do all their requirements which is an additional 3 months. So they may want you to check all their boxes but I hope not. Good luck!!

[GradyCat 3,696]

Oh that's a shame. It seems like they'd count your already completed 3 months of classes as long as they were consecutive without gaps. I had to wait an extra 3 months because my insurance was changing and I didn't have time to get six months of supervised medical weight loss management under my prior policy and my new policy didn't require it.

[New&Improved 1,780]

Why are your insurance companies so mean with so many hoops. You pay for a service from them they shouldn't ask you for so much