Highmark BCBS of PA

lesleyhpr08 · December 28, 2008

Just wondering about the chance of getting approved without the 6 months of supervised dieting? I have a BMI of 54 for more than 5 years. I haven't really done any dieting since the birth of my son. He will be 2 in April. Thanks.

Mr. Green · December 29, 2008

Well, you need to check the requirements of the insurance. I have UPMC and they require a 6 month diet, fitness, etc. with no gain. If your insurance requires it, then it needs to be done to show you can change your lifestyle with the band and eat correctly and exercise. All of this has to be documented by a doctor or the surgical group. It is tough I know, but the 6 months do go by fast and if you need to show a loss, it usually is only a few pounds a month that is documented. You are going to change your lifestyle if you get the band so no better time to start than the 6 or 8 months before you get it.

lesleyhpr08 · December 30, 2008

Thank you Mr. Green. I know I need to work on the liver issue too. I just really want to combine the 2 surgeries so I hopefully won't ever have surgery again. It's hard not to be impatient.:frown:

watermelon_1 · January 19, 2009

I hate to disappoint you but I filed in July with this insurance company and they turned me down because I didn't have the 6 months of a dr visit with a supervised diet. I had 9 months of weight watchers with a loss but they still wanted the dr visits. Well Jan 05 I met my 6 visits and my case is in review again but it's not going to matter because my husband was laid off from his job on Jan 16 and I now have no insurance because of the union contract with the company. I'm still curious to see why they deny me this time.