Who determines if you have to go on a pre-surgery supervised weight loss program?

[JustinsMama 1]

The surgeon or the insurance company? I called BCBSNC to see if I was covered. I was told under our plan it was if deemed medically neccessary (minus the $1,000 family deductible) (we have PPO-Blue Options 123). I then asked who determines if you have to go through a supervised diet before being approved. The BCBS rep told me that was up to the doctor, if he said I needed a 2 month or whatever prediet first, that BCBS would pay for it if the doctor deemed it was neccessary.

It just seems on here that I read it that when people say they have to diet for 6-12 months first before approval that it is the insurance company making them jump through this hoop. Anyone have any input?

Thanks in advance!

[Wheetsin 714]

Insurance requirements. Some sugeons may require patients to lose X lbs or X% of weight before they will do the procedure, but medically supervised diets are in the realm of the insurance companies.

Most of the time, anyway. I would imagine there could be an exception out there somewhere.

[OH Juli 15]

It was my insurance who said I needed 6 months of dr. supervised dieting.

[that.gurl03 0]

From what my doc said it's typically the insurance co. (Mine did) but.. at my doc's office the have people go through a 4-5 week "pre-op nutrition" program. Which the person in charge of that said I may be able to have waived since I went through 6 mos that my insurance required. So I guess my answer is it just depends on what your doc & insurace decide.

[JustinsMama 1]

Thanks for the responses!