Frustrated :(

[PSJ71 0]

Hi All,

Well, I went to my second seminar tonight with a new doctor and I have to say this new doc is wonderful! I know he's definitely the one I want to do my surgery, if I get to have it. Well, I had contact my insurance company in July to see if they cover everything. Of course they do. I have Blue Shield of CA. They also told me about covering the psych eval, nutritionist everything. However, the lady who handles insurance at this doctor's office told me that I would have to go on a 6-month supervised diet....My insurance never mentioned that and I have been trying to look up information on it and I don't see anything to that effect. I see they want a diet history. I have been heavy my whole life. I have tried many diets. Just this year I started WW in February and stopped in May and had lost 13 pounds. I have pictures of myself as a kid and as an adult showing how heavy I have always been!!

I am so frustrated. I really don't want to have to go through this 6-month thing. I'm going to call my insurance myself in the morning and find out if they do require this. I can't find anything in the handbook about it for sure.

Anyway, I had to vent and thank you for listening. :thumbup:

Paulette

[Roxann 0]

I have BCBS of MASS. I did not have to do the 6 months pre diet. I was approved in less then two weeks after my Dr submitted the paperwork to my insurance. I was also asked by my surgeon if I have done the 6 months supervised diet and I told them no that my insurnace does not require it. I now have a surgery date of 10/6

good luck

[DanaM 0]

I have BCBS of Alabama and I had to do the 6 month diet but it was worth it. After I finished my 6 months the insurance approved me with a week. Good luck!

[PSJ71 0]

Thank you both so much for your replies. I am going to check into it further and make sure. I will call them later on this morning and see if they can tell me.

Thank you again,

[SaraJaneQ 0]

Some doctors have different standards/requirements than others. Its very possible that yours just requires a 6 month of everyone. I know my doc required me to do things that my insurance did not need.

My thought on it (not that this works for everyone) is yes, I had to do some crazy dieting and have extra tests, but that is the tradeoff for having a very experienced, careful, thorough doctor. Knowing what I do now, I don't think I could have switched to another doc - because his thoroughness makes me feel like he is going above and beyond to make sure I am as healthy as possible.

If the 6 month is too much for you, maybe you want to interview other docs?

[PSJ71 0]

I am sure it's not the doctor. She said it was my insurance. So, I just got up, as I work third shift, I am going to make a quick phone call. Then, if they happen to say no, then I will call the lady and tell her. It could be that she deals with so many different kinds of insurance she may have just gotten confused. I will keep my fingers crossed. I really, really like this doc though. Thank you so much for your response :omg_smile:

[*slim* 2]

I have BCBSIL and they required a six month supervised diet attempt, BUT it just had to be in the last 2 years. My PCP filled out the paperwork showing that I had been over a 6 month period in 2006. My insurance accepted that as my 6 month diet. Good luck to you with your insurance.

[PSJ71 0]

Whooohooo, I called the insurance company and talked to Medical Management and they said there is nothing in the policy that says I have to do a 6-month supervised diet!!!! Yipeeeeee :scared2: I am very, very happy. :omg_smile:

[bklyn1984 0]

My surgeons office required me to do tests and provide written documentation of weight loss, letters of clearance from the cardiac doctor, primary doctor, and pulmonary/sleep doctor. My insurance says if your BMI is 40 + the only other thing I required was the psychological exam. I confirmed this with my insurance BCBS Federal.

Even though my surgeons office said it's insurance it's them not the insurance. It's fine because I found that I have sleep Apnea and if I did not do the pulmonary/sleep part I would have never known because my test two years ago said I did not have it.

[PSJ71 0]

Ah ha, see. The lady I talked to with my insurance today told me sort of the same thing. She said maybe your doctor wants the 6-month diet done, and I said I don't think so? Because they said that YOU guys said I had to have a 6-month diet. So, she asked me if she could put me on hold and get clarification through the policy. She came back and said she saw nothing in the policy that requires a 6-month supervised diet. So....hmm.... could be the surgeon then? Well, I don't mind the extensive testing at all. I have often wondered if I have sleep apnea and may be this will shed some light on possible other issues I may have. I already know I have hypothyroidism and hypoglycemia and PCOS. But, there could be other things as well. Thank you for your response!! :omg_smile:

[CHI-Girl 1]

Roxann, do you remember what your policy stated? My just says I have to have attempted non surgical methods. Nothing in their that states 6 months, so I'm hoping I'm all good. Although I've been attempting to lose I'm sure for about 6 months really more, but not sure if documented.

[PSJ71 0]

The lady at the doctor's office called my insurance today and found out I was right. I don't have to follow a 6-month supervised diet. I did find my weight watcher's card for this year just in case. But, I am tickled pink I don't have to prolong it with having to do that. :sad: So, for future reference if anyone else has Blue Shield of CA, they will not have to do a 6-month diet.